Association of Chronic Periodontitis on Alzheimer's Disease or Vascular Dementia

OBJECTIVES Although chronic periodontitis has been associated with Alzheimer's disease, the effect of chronic periodontitis on vascular dementia as well as the role of lifestyle behaviors such as smoking, alcohol consumption, and physical activity in this association are still unclear. DESIGN Retrospective cohort study. SETTING Population based. PARTICIPANTS The study population was derived from the Korean National Health Insurance Service-Health Screening Cohort. Among 262 349 participants, diagnosis of chronic periodontitis was determined during 2003-2004. MEASUREMENTS Starting from 2005, participants were followed up for overall dementia, Alzheimer's disease, and vascular dementia until 2015. Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of dementia according to chronic periodontitis. RESULTS Compared with nonchronic periodontitis participants, chronic periodontitis patients had elevated risk for overall dementia (aHR = 1.06; 95% CI = 1.01-1.11) and Alzheimer's disease (aHR = 1.05; 95% CI = 1.00-1.11). There was a tendency toward increased vascular dementia risk among chronic periodontitis patients (aHR = 1.10; 95% CI = 0.98-1.22). The risk-increasing effect of chronic periodontitis on dementia tended to be stronger among participants with healthy lifestyle behaviors including never-smokers and those who exercised and did not consume alcohol. CONCLUSION Chronic periodontitis may be associated with a higher risk of developing dementia. Future studies that investigate whether preventing chronic periodontitis may lead to reduced risk of dementia are needed.