痴呆症和牙周炎风险：基于人群的队列研究。
Dementia and the Risk of Periodontitis: A Population-Based Cohort Study.
机构信息
Center for Global Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Graduate Institute of Biomedical Electronics and Bioinformatics, College of Electrical Engineering and Computer Science, National Taiwan University, Taipei.
出版信息
J Dent Res. 2022 Mar;101(3):270-277. doi: 10.1177/00220345211037220. Epub 2021 Oct 13.
Dementia and Alzheimer's disease (AD) are proposed to be comorbid with periodontitis (PD). It is unclear whether PD is associated with dementia and AD independent of confounding factors. We aimed at identifying the relationship between the longitudinal risk of developing PD in a cohort of patients with dementia and AD who did not show any signs of PD at baseline. In this retrospective cohort study, 8,640 patients with dementia without prior PD were recruited, and 8,640 individuals without dementia history were selected as propensity score-matched controls. A Cox proportional hazard model was developed to estimate the risk of developing PD over 10 y. Cumulative probability was derived to assess the time-dependent effect of dementia on PD. Of the 8,640 patients, a sensitivity test was conducted on 606 patients with AD-associated dementia and 606 non-AD propensity score-matched controls to identify the impact of AD-associated dementia on the risk for PD. Subgroup analyses on age stratification were included. Overall 2,670 patients with dementia developed PD. The relative risk of PD in these patients was significantly higher than in the nondementia group (1.825, 95% CI = 1.715 to 1.942). Cox proportional hazard models showed that patients with dementia were more likely to have PD than individuals without dementia (adjusted hazard ratio = 1.915, 95% CI = 1.766 to 2.077, < 0.0001, log-rank test < 0.0001). The risk of PD in patients with dementia was age dependent ( values for all ages <0.0001); younger patients with dementia were more likely to develop PD. The findings persisted for patients with AD: the relative risk (1.531, 95% CI = 1.209 to 1.939) and adjusted hazard ratio (1.667, 95% CI = 1.244 to 2.232; log-rank test = 0.0004) of PD in patients with AD were significantly higher than the non-AD cohort. Our findings demonstrated that dementia and AD were associated with a higher risk of PD dependent of age and independent of systemic confounding factors.
痴呆症和阿尔茨海默病（AD）被认为与牙周炎（PD）共存。目前尚不清楚 PD 是否与痴呆症和 AD 相关，而与混杂因素无关。我们的目的是确定在一组没有任何 PD 迹象的痴呆症和 AD 患者中，PD 的纵向发病风险。在这项回顾性队列研究中，招募了 8640 名没有 PD 既往史的痴呆症患者，并选择了 8640 名没有痴呆症病史的个体作为倾向评分匹配对照。采用 Cox 比例风险模型来估计 10 年内 PD 的发病风险。得出累积概率以评估痴呆症对 PD 的时间依赖性影响。在 8640 名患者中，对 606 名 AD 相关痴呆症患者和 606 名非 AD 倾向评分匹配对照进行了敏感性测试，以确定 AD 相关痴呆症对 PD 风险的影响。包括年龄分层的亚组分析。共有 2670 名痴呆症患者发展为 PD。这些患者 PD 的相对风险明显高于非痴呆症组（1.825，95%CI=1.715 至 1.942）。Cox 比例风险模型显示，痴呆症患者比无痴呆症患者更有可能患有 PD（调整后的危险比=1.915，95%CI=1.766 至 2.077，<0.0001，对数秩检验<0.0001）。痴呆症患者的 PD 发病风险与年龄相关（所有年龄组的 值均<0.0001）；年龄较小的痴呆症患者更有可能发展为 PD。这一发现也适用于 AD 患者：AD 患者的相对风险（1.531，95%CI=1.209 至 1.939）和调整后的危险比（1.667，95%CI=1.244 至 2.232；对数秩检验=0.0004）均显著高于非 AD 队列。我们的研究结果表明，痴呆症和 AD 与 PD 相关，这种相关性与年龄有关，与系统混杂因素无关。
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