Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis

Gusman, David Jonathan Rodrigues; Mello‐Neto, João Martins de; Alves, Breno Edson Sendão; Matheus, Henrique R.; Ervolino, Edílson; Theodoro, Letícia Helena

doi:10.1016/j.archger.2018.02.016

Cited by 17 publications

(13 citation statements)

References 48 publications

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“…Given the prevalence of periodontitis and various dementias such as Alzheimer's disease increase with age, positive associations are expected. The present findings concur with other reviews recently published in this field [46][47][48][49]. Poor oral hygiene, periodontal disease and dental morbidity have been correlated with the presence and increased severity of dementia [40].…”

Section: Discussionsupporting

confidence: 93%

The association between periodontal disease and dementia: a systematic review and meta-analysis

Ju¹,

Kapellas²,

Jamieson³

et al. 2019

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Background and Objective: Periodontal disease is a chronic infection and inflammatory condition of the tooth-supporting tissues. Dementia is a degenerative condition of the brain affecting memory and brain function. The objective of this review is to evaluate associations between the two conditions. Methods: Systematic review with meta-analysis of published articles that involved participants aged ≥45 years with either periodontal disease or dementia. Electronic database searches of PubMed, Embase, Web of Science and Scopus were conducted to source articles that met the inclusion criteria. The Newcastle-Ottawa Scale was used for quality appraisal. Two random effects meta-analyses were conducted to investigate the bi-directional association between periodontitis and dementia. Results: Of 1,670 titles and abstracts found, quality assessment was conducted on 23 articles that met the inclusion criteria. Eight articles presenting findings on the association between dementia and periodontitis, and four studies on the converse association, were subsequently combined into meta-analysis. People with periodontal disease are more likely to suffer from dementia (Odds Ratio=1.17, 95% CI=1.02-1.34, P heterogeneity=0.33, I2 =13%). Conversely, people with dementia are 69% more likely to have periodontal disease (Odds Ratio =1.69, 95% CI=1.23-2.30, P heterogeneity=0.00, I2 =76%). Conclusion: A bi-directional association exists between periodontitis and dementia. With the aging population increasing, degenerative conditions such as dementia and periodontal disease are becoming more common. Family members and healthcare providers need to be aware that the effects of dementia may impede adequate oral hygiene, the cornerstone of prevention of periodontitis, and increase the likelihood of periodontal disease.

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Section: Discussionsupporting

confidence: 93%

The association between periodontal disease and dementia: a systematic review and meta-analysis

Ju¹,

Kapellas²,

Jamieson³

et al. 2019

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“…Diagnosis of clinically verified severe PD was associated with cognitive impairment with an OR of 3.04 (95% CI = 1.69–5.46) compared with our finding of 5.81 (95% CI = 1.14–29.68). Several systematic reviews have recently been published to determine whether the available evidence supports the proposed risk contribution of PD to the development of dementia (Gusman et al., ; Leira, Domínguez, et al., ; Maldonado, Laugisch, Bürgin, Sculean, & Eick, ; Tonsekar, Jiang, & Yue, ). Leira, Domínguez, et al.…”

Section: Discussionmentioning

confidence: 99%

Association between periodontitis and risk of Alzheimer′s disease, mild cognitive impairment and subjective cognitive decline: A case–control study

Holmer

Eriksdotter

Schultzberg

et al. 2018

J Clinic Periodontology

144

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Aims To test the hypothesis that periodontal disease contributes to increased risk of mild cognitive impairment (MCI), subjective cognitive decline (SCD) and Alzheimer′s disease (AD). Materials and methods This case–control study was conducted over a 3‐year period in the municipality of Huddinge, Sweden. In total, 154 cases were consecutively enrolled from the Karolinska Memory Clinic at the Karolinska University Hospital and allotted to three diagnostic groups: AD, MCI and SCD, collectively referred to as “cases.” Seventy‐six cognitively healthy age‐ and gender‐matched controls were randomly sampled through the Swedish population register. All cases and controls underwent clinical and radiographic oral examinations. Statistical analysis was based on logistic regression models adjusted for potential confounders. Results Poor oral health and marginal alveolar bone loss were more prevalent among cases than among controls. The cases group was associated with generalized marginal alveolar bone loss (odds ratio [OR] = 5.81; 95% confidence interval [CI] = 1.14–29.68), increased number of deep periodontal pockets (OR = 8.43; CI 4.00–17.76) and dental caries (OR = 3.36; CI 1.20–9.43). Conclusion The results suggest that marginal periodontitis is associated with early cognitive impairment and AD. However, the study design does not preclude noncausal explanations.

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“…Recent systematic reviews suggest that older people with dementia have multiple oral health problems (Delwel et al, 2018;Gusman et al, 2018;Leira et al, 2017;Maldonado, Laugisch, Burgin, Sculean, & Eick, 2018). However, studies on the relationship between periodontitis and cognitive decline are few but indicate an association (Gil-Montoya et al, 2014;Syrjala et al, 2012;Zenthofer et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal evaluation of periodontitis and development of cognitive decline among older adults

Nilsson

Berglund

Renvert

2018

J Clinic Periodontology

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Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis

Abstract: Although the qualitative analysis have suggested worse periodontal conditions in dementia patients, due to different study types and the high heterogeneity among them, the meta-analysis does not support the association between dementia and severity of periodontal disease.

Cited by 17 publications

References 48 publications

The association between periodontal disease and dementia: a systematic review and meta-analysis

The association between periodontal disease and dementia: a systematic review and meta-analysis

Association between periodontitis and risk of Alzheimer′s disease, mild cognitive impairment and subjective cognitive decline: A case–control study

Longitudinal evaluation of periodontitis and development of cognitive decline among older adults

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