Lee Chia-Yen, Chang Chuen-Chau, Lin Chao-Shun, Yeh Chun-Chieh, Hu Chaur-Jong, Wu Ching-Zong, Chen Ta-Liang, Liao Chien-Chang
Department of Dentistry, Taiwan Adventist Hospital, Taipei, Taiwan.
School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
J Clin Periodontol. 2020 Dec;47(12):1428-1436. doi: 10.1111/jcpe.13372. Epub 2020 Nov 11.
We aimed to evaluate the long-term risk of dementia in patients with periodontitis and its associated factors.
Using Taiwan's National Health Insurance Database, we identified 56,018 patients aged ≥50 years with newly diagnosed periodontitis in 2000-2008. A cohort of 56,018 adults without periodontitis was selected for comparison, with matching by age and sex. Both cohorts were followed from 2000 to the end of 2013, and incident dementia was identified during the follow-up period. Adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of dementia associated with periodontitis were calculated in the multivariate regressions.
Periodontitis was associated with dementia risk (HR: 1.79, 95% CI: 1.67-1.93), and the association between periodontitis and dementia risk was significant in men, women, and people aged more than 60 years. Among patients with periodontitis, the use of statins (HR: 0.78, 95% CI: 0.71-0.87), metformin (HR: 0.53, 95% CI: 0.44-0.62), and influenza vaccination (HR: 0.67, 95% CI: 0.61-0.74) were associated with a reduced risk of dementia, while diabetes, mental disorders, and stroke were major significant risk factors.
Periodontitis was a risk factor for dementia, while the use of statins and metformin may reduce the risk of dementia.
我们旨在评估牙周炎患者患痴呆症的长期风险及其相关因素。
利用台湾国民健康保险数据库，我们确定了2000年至2008年间新诊断为牙周炎的56018名年龄≥50岁的患者。选取56018名无牙周炎的成年人作为对照组，按年龄和性别进行匹配。两个队列均从2000年随访至2013年底，随访期间确定新发痴呆症病例。在多变量回归中计算与牙周炎相关的痴呆症调整风险比（HR）和95%置信区间（CI）。
牙周炎与痴呆症风险相关（HR：1.79，95%CI：1.67 - 1.93），牙周炎与痴呆症风险之间的关联在男性、女性以及60岁以上人群中均显著。在牙周炎患者中，使用他汀类药物（HR：0.78，95%CI：0.71 - 0.87）、二甲双胍（HR：0.53，95%CI：0.44 - 0.62）和流感疫苗接种（HR：0.67，95%CI：0.61 - 0.74）与痴呆症风险降低相关，而糖尿病、精神障碍和中风是主要的显著风险因素。
牙周炎是痴呆症的一个风险因素，而使用他汀类药物和二甲双胍可能降低痴呆症风险。
