Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada.
Psychology Department, Concordia University, Montreal, Canada.
JDR Clin Trans Res. 2024 Jul;9(3):294-305. doi: 10.1177/23800844231190834. Epub 2023 Aug 22.
Poor oral health has been suggested as a risk factor for cognitive decline. Yet, biologically plausible mechanisms explaining this relationship remain unknown.
We aimed (1) to identify oral and cognitive health clustering patterns among middle-aged to elderly Canadians and (2) to investigate the extent to which these patterns could be explained by bone mineral density (BMD), a proxy measure of the cholinergic neurons' activity.
This cross-sectional study used baseline data from the Comprehensive cohort of the Canadian Longitudinal Study of Aging (CLSA). Oral health was assessed by a self-report questionnaire, and 7 task-based instruments measured cognitive health. We identified oral and cognitive health clusters, our outcome variables, using latent class analysis. Two sets of multivariate logistic regression and 95% confidence intervals were used to investigate whether BMD explains the odds of membership in a certain oral and cognitive health group. The final models were adjusted for socioeconomic, health, and lifestyle factors.
Our study sample (N = 25,444: 13,035 males, 12,409 females) was grouped into 5 and 4 clusters based on the oral health status and performance on the cognitive tasks, respectively. After adjusting for all potential covariates, increase in BMD was not associated with higher odds of membership in classes with better oral health (odds ratio [OR] = 1.58 [95% confidence interval {CI}: 0.85-2.92]) and cognitive health (OR = 1.61 [95% CI: 1-2.6]) compared with the groups with the least favorable oral and cognitive health status, respectively.
Middle-aged and elderly Canadians show different oral and cognitive health profiles, based on their denture-wearing status and performance on cognitive tests. No evidence could be found to support BMD in place of cholinergic neurons' activity as the common explanatory factor behind the association between oral health and cognitive health.
This study is probably the first of its kind to shed light on the cholinergic system as a potential pathway influencing oral and cognitive health. Our findings may support the notion that any potential association between poor oral health and cognitive health might be explained by common contributors, helping clinicians to find the common risk factors for both conditions.
较差的口腔健康状况被认为是认知能力下降的一个风险因素。然而，解释这种关系的生物学上合理的机制尚不清楚。
我们旨在（1）确定中年至老年加拿大人的口腔和认知健康聚类模式，（2）研究这些模式在多大程度上可以用骨密度（BMD）来解释，BMD 是胆碱能神经元活动的替代指标。
本横断面研究使用了加拿大老龄化纵向研究（CLSA）综合队列的基线数据。口腔健康状况通过自我报告问卷进行评估，7 项基于任务的仪器测量认知健康状况。我们使用潜在类别分析确定了口腔和认知健康聚类，这是我们的结果变量。使用两组多变量逻辑回归和 95%置信区间来调查 BMD 是否解释了属于特定口腔和认知健康组的几率。最终模型调整了社会经济、健康和生活方式因素。
我们的研究样本（N=25444：13035 名男性，12409 名女性）根据口腔健康状况和认知任务的表现分为 5 组和 4 组。在调整所有潜在混杂因素后，BMD 的增加与更好的口腔健康（比值比[OR]=1.58[95%置信区间{CI}：0.85-2.92]）和认知健康（OR=1.61[95% CI：1-2.6]）的几率增加无关，与各自最不利的口腔和认知健康状况相比，分别属于具有相似特征的群体。
中年和老年加拿大人根据戴假牙的状况和认知测试的表现，表现出不同的口腔和认知健康特征。没有证据支持 BMD 可以替代胆碱能神经元的活动作为口腔健康和认知健康之间关联的共同解释因素。
这项研究可能是首次揭示胆碱能系统作为影响口腔和认知健康的潜在途径的研究之一。我们的研究结果可能支持这样一种观点，即较差的口腔健康状况与认知健康状况之间的任何潜在关联都可以用共同的促成因素来解释，这有助于临床医生找到这两种疾病的共同危险因素。
