Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 61, Issue 2, Pages 177-184Publisher
WILEY
DOI: 10.1111/jgs.12094
Keywords
cognitive decline; cognitive impairment; periodontitis; periodontal disease; gingivitis
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Funding
- Wellcome Trust
- National Institute for Health Research (NIHR) Biomedical Research Centre
- Dementia Biomedical Research Unit at South London
- Maudsley NHS Foundation Trust
- King's College London
- Pfizer
- Eisai
- Lunbeck
- JJ
- Roche
- National Institute for Drug Abuse
- National Institute for Dental and Craniofacial Research
- Health Resources and Services Administration
- University of Padua
- University of Verona
- Imperial College London
- U.S. Public Health Service [N01-AG-6-2103, 1R01AG028050, N01-AG-6-2106]
- NIH
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OBJECTIVES: To investigate the relationship between periodontal disease and cognitive decline. DESIGN: Analysis of a prospective cohort study. SETTING: The Health, Aging and Body Composition (Health ABC) Study. PARTICIPANTS: One thousand fifty-three participants who were administered the Modified Mini-Mental State Examination (3MS) at Year 1 (baseline) and Year 3 and had participated in a comprehensive periodontal examination at Year 2. MEASUREMENTS: The prospective association between a range of oral health parameters and cognitive function was examined. Decline in 3MS score from Year 3 to 5 was investigated in 947 (89.9%) participants. Covariates included age, sex, education, race, cardiovascular disease and risk, and depressive symptoms. RESULTS: Most indicators of adverse oral health at Year 2 were associated with cognitive impairment based on averaged 3MS scores less than 80 for Years 1 and 3, but education and race substantially confounded these associations. Higher gingival index, a measure of gingival inflammation, at Year 2 remained independently associated with this definition of cognitive impairment and, in fully adjusted analyses, was also an independent predictor of a more-than-5-point cognitive decline from Year 3 to S. CONCLUSION: Periodontitis may be a risk factor for cognitive decline. Gingivitis is reversible, and periodontitis to some degree is preventable and controllable when manifest. Therefore, further research is needed to clarify potential underlying mechanisms and oral health interventions that might ameliorate cognitive decline. J Am Geriatr Soc 61:177-184, 2013.
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