Tooth loss, periodontal disease, and cognitive decline in the Atherosclerosis Risk in Communities (<scp>ARIC</scp>) study

Naorungroj, Supawadee; Schoenbach, Victor J.; Wruck, Lisa; Mosley, Thomas H.; Gottesman, Rebecca F.; Alonso, Álvaro; Heiss, Gerardo; Beck, James D.; Slade, Gary D.

doi:10.1111/cdoe.12128

Cited by 67 publications

(111 citation statements)

References 35 publications

Supporting

Mentioning

110

Contrasting

Order By: Relevance

“…It has been suggested that sites of periodontal infection could be significant sources of inflammatory mediators and bacterial components, which may enter the central nervous system and cause neuronal damage . Although the evidence supporting the potential association between periodontitis and cognitive impairment is increasing, the results from previous studies are not consistent with those from several studies that did not find any significant association between periodontitis and cognitive impairment. It should be noted that there is not enough evidence to draw definite conclusions; additional well‐designed research is warranted in this field.…”

Section: Discussionmentioning

confidence: 91%

See 1 more Smart Citation

Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5‐year cohort study

Iwasaki

Kimura

Ogawa

et al. 2018

J of Periodontal Research

105

View full text Add to dashboard Cite

Background and Objectives Identification of modifiable factors for mild cognitive impairment (MCI) is important since individuals with MCI are at a high risk of dementia and disability. Previous studies have suggested a potential association between periodontitis and cognitive impairment, but the results remain inconclusive. We designed a 5‐year longitudinal study to explore the association between MCI and periodontitis and periodontal inflammation in older adults. Methods This study included 179 community‐dwelling dentate individuals (62 men and 117 women, average age: 80.1 years). A full‐mouth periodontal examination at six sites per tooth was performed at baseline. Case definitions provided by the European Workshop in Periodontology Group C (EWP definition) and the Centers for Disease Control/American Academy of Periodontology (CDC/AAP definition) were used to define severe periodontitis. Additionally, the periodontal inflamed surface area (PISA), reflecting the amount of inflamed periodontal tissue, was calculated using clinical periodontal parameters. Follow‐up cognitive examinations for MCI diagnosis were performed by neurologists 1, 2, 3, and 5 years after baseline. Odds ratios (ORs) for MCI according to the presence of periodontitis and periodontal inflammation at baseline were calculated using multilevel mixed‐effects logistic regression. Results At baseline, 56.4% and 27.4% of the participants had severe periodontitis by the EWP and CDC/AAP definitions, respectively. After adjusting for follow‐up period and other baseline health characteristics (age, sex, smoking status, educational level, physical activity level, obesity, depression, and diabetes), severe periodontitis by either definition was significantly associated with MCI (for the EWP definition: adjusted OR = 3.58, 95% confidence interval [CI] = 1.45‐8.87; for the CDC/AAP definition: adjusted OR = 2.61, 95% CI = 1.08‐6.28). Periodontal inflammation assessed by PISA was also significantly associated with a higher OR for MCI (adjusted OR = 1.05, 95% CI = 1.01‐1.10, per 10‐mm2 increase in PISA). Conclusion Severe periodontitis and periodontal inflammation were associated with incident MCI among older community‐dwelling men and women.

show abstract

Section: Discussionmentioning

confidence: 91%

“…A putative link between periodontitis and cognitive impairment/dementia has been reported . There are several possible underlying mechanisms for this association.…”

Section: Introductionmentioning

confidence: 99%

Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5‐year cohort study

Iwasaki

Kimura

Ogawa

et al. 2018

J of Periodontal Research

105

View full text Add to dashboard Cite

show abstract

“…This prospective cohort study of an elderly Japanese population demonstrated an inverse association between number of remaining teeth and risk of development of all‐cause dementia and AD, indicating that subjects with greater tooth loss were at greater risk of onset of dementia. Tooth loss was estimated using data from clinical oral examinations performed by dentists, and dementia subtypes were determined on the basis of brain morphological data (neuroimaging and neuropathology), unlike previous studies . The present prospective cohort study investigated the association between tooth loss evaluated through a professional oral examination and risk of dementia and its subtypes in an elderly general population.…”

Section: Discussionmentioning

confidence: 99%

Tooth Loss and Risk of Dementia in the Community: the Hisayama Study

Takeuchi

Ohara

Furuta

et al. 2017

J American Geriatrics Society

114

131

View full text Add to dashboard Cite

OBJECTIVES:To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population. DESIGN: Prospective cohort study. SETTING: The Hisayama Study, Japan. PARTICIPANTS: Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for 5 years (2007)(2008)(2009)(2010)(2011)(2012). MEASUREMENTS: Participants were classified into four categories according to baseline number of remaining teeth (≥20, 10-19, 1-9, 0). The risk estimates of the effect of tooth loss on the development of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) were computed using a Cox proportional hazards model. RESULTS: During follow-up, 180 (11.5%) subjects developed all-cause dementia; 127 (8.1%) had AD, and 42 (2.7%) had VaD. After adjusting for potential confounders, there was a tendency for the multivariableadjusted hazard ratio of all-cause dementia to increase with decrease in number of remaining teeth (P for trend = .04). The risk of all-cause dementia was 1.62 times as great in subjects with 10 to 19 teeth, 1.81 times as great in those with one to nine teeth, and 1.63 times as great in those with no teeth as in those with 20 teeth or more. An inverse association was observed between number of remaining teeth and risk of AD (P for trend = .08), but no such association was observed with risk of VaD (P for trend = .20).CONCLUSION: Tooth loss is associated with an increased risk of all-cause dementia and AD in the Japanese population. J Am Geriatr Soc 65:e95-e100, 2017.Key words: Alzheimer's disease; epidemiology; oral health; prospective cohort study; vascular dementia T he increase in the incidence of dementia is a substantial public health concern in aging societies. Approximately 46.8 million people worldwide have dementia, and the incidence is 9.9 million per year.1 The number of people living with dementia will nearly double every 20 years, but the causes of dementia, especially Alzheimer's disease (AD), are unclear, and there is a lack of treatments and health service settings for this disorder.2,3 Therefore, intensified research studies are needed to identify factors that have the potential to decrease the risk of dementia and thereby decrease the burden of this disease on health systems.A growing number of research studies have focused on the link between oral health and cognitive status. In particular, many research studies have assessed the association between number of teeth and cognitive function, [4][5][6][7][8][9][10][11][12][13][14][15] but the results of observational longitudinal studies on the effect of tooth loss on cognitive function are inconsistent. A recent systematic review of the literature suggested that tooth loss was associated with greater risk of cognitive impairment and dementia, 16 whereas another reported that tooth loss was not consistently associated with those outcomes. 17 The inconsistency might be due to methodological deficiencies in this field, such as the lack of representativeness of the ...

show abstract

“…Examples of DD include: Tooth loss, local and/or generalized periodontal detachment, improper operative or prosthetic restorations, and orthodontic managements and the unavoidable consequence of impaired mastication. These DDs may cause sensory and motor cortical reorganization [1–4], affect cerebral functional streams toward multisensory hubs [5,6], impair gustatory, auditory and olfactory perceptions [7–11], and result in memory and cognition impairment [12–30].…”

Section: Introductionmentioning

confidence: 99%

“…The greatest risk factor for cognitive decline and Alzheimer's disease in older adults is age itself [31,32]. Accumulating scientific evidence has indicated a correlation between DD and impaired brain functions such as memory loss, cognitive impairment, and even prodromes of AD and dementia [12–30]. A recent review of both animal trials and clinical research [33] has highlighted the causal relationship of mastication on cognitive functions.…”

Section: Introductionmentioning

confidence: 99%

Dental deafferentation and brain damage: A review and a hypothesis

Jou

2018

The Kaohsiung J of Med Scie

View full text Add to dashboard Cite

In the last few decades, neurobiological and human brain imaging research have greatly advanced our understanding of brain mechanisms that support perception and memory, as well as their function in daily activities. Knowledge of the neurobiological mechanisms behind the deafferentation of stomatognathic systems has also expanded greatly in recent decades. In particular, current studies reveal that the peripheral deafferentations of stomatognathic systems may be projected globally into the central nervous system (CNS) and become an associated critical factor in triggering and aggravating neurodegenerative diseases. This review explores basic neurobiological mechanisms associated with the deafferentation of stomatognathic systems. Further included is a discussion on tooth loss and other dental deafferentation (DD) mechanisms, with a focus on dental and masticatory apparatuses associated with brain functions and which may underlie the changes observed in the aging brain. A new hypothesis is presented where DD and changes in the functionality of teeth and the masticatory apparatus may cause brain damage as a result of altered cerebral circulation and dysfunctional homeostasis. Furthermore, multiple recurrent reorganizations of the brain may be a triggering or contributing risk factor in the onset and progression of neurodegenerative conditions such as Alzheimer's disease (AD). A growing understanding of the association between DD and brain aging may lead to solutions in treating and preventing cognitive decline and neurodegenerative diseases.

show abstract

Tooth loss, periodontal disease, and cognitive decline in the Atherosclerosis Risk in Communities (ARIC) study

Cited by 67 publications

References 35 publications

Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5‐year cohort study

Periodontitis, periodontal inflammation, and mild cognitive impairment: A 5‐year cohort study

Tooth Loss and Risk of Dementia in the Community: the Hisayama Study

Dental deafferentation and brain damage: A review and a hypothesis

Contact Info

Product

Resources

About