Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, No.1, Changde St., Taipei 100229, Taiwan; Department of Dentistry, National Taiwan University Hospital, No.1, Changde St., Taipei 100229, Taiwan.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, No.1, Changde St., Taipei 100229, Taiwan.
J Dent. 2024 Aug;147:105088. doi: 10.1016/j.jdent.2024.105088. Epub 2024 May 25.
OBJECTIVE: This study aims to investigate the relationships between four baseline oral conditions (periodontal status, dental caries, tooth wear, and dentition) and repeated global cognition or domain-specific cognition (memory, executive function, attention, and verbal fluency) in non-demented older adults over time. METHODS: This prospective cohort study (2011-2019) enrolled 516 non-demented community-dwelling older adults (age ≥ 65) to explore the association between oral health and cognitive function. Global and domain-specific cognition were assessed biennially (four repeats) using a battery of neuropsychological tests. The baseline oral health conditions were examined, including periodontal status, dental caries, tooth wear, and dentition. The association of these oral conditions with cognition was evaluated by generalized linear mixed models. Stratified analyses were performed by important covariates. RESULTS: Over time, dental caries was associated with poor memory in two different logical memory tests (β^= -0.06 and β^= -0.04). Incomplete dentition with less than 28 teeth was associated with poor performance in attention (β^= -0.05) and verbal fluency (β^= -0.03). These associations became more evident in those with an elevated inflammatory marker (IL-6, β^= -0.11 to -0.08). In contrast, tooth wear was associated with better memory in two different logical memory tests (β^= 0.33 and β^= 0.36) and better executive function (β^= 0.06) over time, and this association became more evident in those with the lowest inflammatory marker (IL-6, β^= 0.10). CONCLUSIONS: Dental caries and incomplete dentition were associated with poor memory, attention, and verbal fluency performance. Conversely, tooth wear was associated with better memory performance and executive function. CLINICAL SIGNIFICANCE: For early prevention of dementia, an evaluation of multiple dental and periodontal status in older adults helps predict the risk of dementia in the preclinical phase. Maintaining intact tooth structure without caries progression and eventually tooth loss may help prevent the worsening of memory, attention, and verbal fluency over time.
目的：本研究旨在探究四项基线口腔状况（牙周状况、龋齿、牙齿磨损和牙列）与非痴呆老年人群随时间推移重复的整体认知或特定领域认知（记忆、执行功能、注意力和语言流畅性）之间的关系。
方法：本前瞻性队列研究（2011-2019 年）纳入了 516 名无痴呆的社区居住老年受试者（年龄≥65 岁），以探索口腔健康与认知功能之间的关联。整体和特定领域认知采用一系列神经心理学测试进行每两年（共四次重复）评估。基线口腔健康状况检查包括牙周状况、龋齿、牙齿磨损和牙列。使用广义线性混合模型评估这些口腔状况与认知的关系。根据重要的协变量进行分层分析。
结果：随着时间的推移，龋齿与两项不同的逻辑记忆测试中的较差记忆有关（β^= -0.06 和 β^= -0.04）。少于 28 颗牙齿的不完整牙列与注意力（β^= -0.05）和语言流畅性（β^= -0.03）的较差表现相关。这些关联在炎症标志物（IL-6）升高的人群中更为明显（β^= -0.11 至 -0.08）。相反，随着时间的推移，牙齿磨损与两项不同的逻辑记忆测试中的更好记忆（β^= 0.33 和 β^= 0.36）和更好的执行功能（β^= 0.06）相关，而在炎症标志物（IL-6）最低的人群中，这种关联更为明显（β^= 0.10）。
结论：龋齿和不完整牙列与较差的记忆、注意力和语言流畅性表现相关。相反，牙齿磨损与更好的记忆表现和执行功能相关。
临床意义：为了早期预防痴呆症，对老年人群的多项牙齿和牙周状况进行评估有助于在临床前阶段预测痴呆症的风险。保持无龋齿进展和最终牙齿缺失的完整牙体结构可能有助于随着时间的推移预防记忆、注意力和语言流畅性的恶化。
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