Cognitive Impairment

Noble, James M.; Scarmeas, Nikolaos

doi:10.1007/978-0-387-74337-0_6

Cited by 6 publications

(4 citation statements)

References 154 publications

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“…A relatively straightforward argument can be made for cognitive impairment leading to poor dental health: persons with impaired cognition could be inattentive to oral hygiene or oral health maintenance as impairment in cognition progresses 26. Conversely, worth considering is whether poor oral health could contribute to subsequent cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III

Noble

Borrell

Papapanou

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

269

246

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Background: Periodontitis is ubiquitous and associated with serological evidence of exposure to periodontal organisms, systemic inflammation and vascular disease. Dementia is a major public health problem likely related to a complex interaction between genetics and diseases associated with systemic inflammation, including diabetes, smoking and stroke. Methods: To assess relationships between systemic exposure to periodontal pathogens and cognitive test outcomes, data were analysed from the Third National Health and Nutrition Examination Survey (NHANES-III), a nationally representative cross sectional observational study among older adults. We included 2355 participants >60 years who completed measures of cognition and Poryphyromonas gingivalis IgG. Using SUDAAN, logistic regression models examined the association of P gingivalis IgG with cognitive test performance. Results: Poor immediate verbal memory (,5/9 points) was prevalent in 5.7% of patients, and 6.5% overall had impaired delayed recall (,4/9); 22.1% had difficulty with serial subtractions (,5/5 trials correct). Individuals with the highest P gingivalis IgG (.119 ELISA Units (EU)) were more likely to have poor delayed verbal recall (OR 2.89, 95% CI 1.14 to 7.29) and impaired subtraction (OR 1.95, 95% CI 1.22 to 3.11) than those with the lowest ((57 EU), with dose-response relationships for both (p trend, delayed memory = 0.045, subtraction = 0.04). After adjusting for socioeconomic and vascular variables, these relationships remained robust for the highest P gingivalis IgG group (delayed verbal memory OR 3.01 (95% CI 1.06 to 8.53); subtraction OR 2.00 (95% CI 1.19 to 3.36)). In contrast, immediate verbal memory was not significantly associated with P gingivalis. Conclusion: A serological marker of periodontitis is associated with impaired delayed memory and calculation. Further exploration of relationships between oral health and cognition is warranted.

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Section: Discussionmentioning

confidence: 99%

Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III

Noble

Borrell

Papapanou

et al. 2009

Journal of Neurology, Neurosurgery & Psychiatry

269

246

View full text Add to dashboard Cite

show abstract

“…Cognition and dental health may be related in several ways: A compelling and rather straight-forward argument can be made for cognitive impairment leading to poor dental health. That is, persons with impaired cognition may be expected to be inattentive to oral hygiene or may have restricted access to routine oral care as cognitive disease progresses, 7 and thus have worse dental health. Conversely, worth considering is whether poor oral health could instead be an antecedent condition, possibly contributing to subsequent cognitive impairment as a causal exposure, rather than as an outcome.…”

Section: Introductionmentioning

confidence: 99%

Poor Oral Health as a Chronic, Potentially Modifiable Dementia Risk Factor: Review of the Literature

Noble

Scarmeas

Papapanou

2013

Curr Neurol Neurosci Rep

Self Cite

121

118

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Poor oral health, including caries, tooth loss, and periodontitis, is ubiquitous worldwide, and is potentially treatable and preventable. Like adverse oral health conditions, Alzheimer disease and related disorders are also very common among aging populations. Established risk factors for Alzheimer disease include cerebrovascular disease and its vascular risk factors, many of which share associations with evidence of systemic inflammation also identified in periodontitis and other poor oral health states. In this review, we present epidemiologic evidence of links between poor oral health and both prevalent and incident cognitive impairment, and review plausible mechanisms linking these conditions, including evidence from compelling animal models. Considering that a large etiologic fraction of dementia remains unexplained, these studies argue for further multidisciplinary research between oral health conditions, including translational, epidemiologic, and possibly clinical treatment studies.

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“…These results verified the periodontal tissue abnormalities in naive dKO mice found in our previous studies. As mentioned in the introduction, people with impaired cognition might be inattentive to oral hygiene or oral health maintenance, which results in poorer dental health [28]. Since no mice received oral care treatment in this study, our results indicate that inflammatory response is the most likely cause of the periodontal tissue abnormalities found in dKO mice.…”

Section: Resultsmentioning

confidence: 59%

“…As mentioned above, a relatively straightforward argument was made for cognitive impairment leading to poor dental health: People with impaired cognition might be inattentive to oral hygiene or oral health maintenance as impairment in cognition progresses [28]. Our colleagues have found that ibuprofen partly alleviates learning and memory deficits in dKO mice [29].…”

Section: Resultsmentioning

confidence: 99%

Ibuprofen Rescues Abnormalities in Periodontal Tissues in Conditional Presenilin 1 and Presenilin 2 Double Knockout Mice

Dong

et al. 2013

IJMS

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We used forebrain-specific conditional presenilin 1 (PS1) and presenilin 2 (PS2) double knockout mice (dKO mice) that exhibit symptoms of neurodegenerative diseases, especially Alzheimer’s disease, to investigate whether ibuprofen can rescue brain and periodontal tissue abnormalities by attenuating the inflammatory response. Mandibles were dissected for alveolar bone-height analysis. Maxillae were fixed and decalcified for histological observation and osteoclast detection. ELISA measurements from the hippocampus, cortex, and gingiva of the mandibular incisor teeth were used to assay inflammatory mediators. We confirmed periodontal tissue abnormalities and inflammatory responses in brain and periodontal tissues in naive nine- and 12-month-old dKO mice. The other two groups of age-matched dKO mice that received 375-ppm ibuprofen treatment for six consecutive months exhibited significantly attenuated damage in periodontal tissues and reduction in several inflammation-related factors in brain and periodontal tissues. Our findings showed that the anti-inflammatory drug ibuprofen significantly decreased inflammation through the cyclooxygenase (COX) pathway in brain and periodontal tissues in dKO mice, and then attenuated abnormalities in periodontal tissues. This suggests that ibuprofen could be an ideal drug for preventing both nervous system and periodontal tissue damage caused by inflammatory responses.

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Cognitive Impairment

Cited by 6 publications

References 154 publications

Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III

Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III

Poor Oral Health as a Chronic, Potentially Modifiable Dementia Risk Factor: Review of the Literature

Ibuprofen Rescues Abnormalities in Periodontal Tissues in Conditional Presenilin 1 and Presenilin 2 Double Knockout Mice

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