Periodontal disease may be a modifiable risk factor for dementia

  • Demmer RT & al.
  • Neurology
  • 29 Jul 2020

  • curated by Susan London
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • Community-dwelling individuals who had severe periodontal disease or had lost all of their teeth were more likely to develop dementia over the next few decades.

Why this matters

Key results

  • During a median 18.4-year follow-up:
    • Cumulative incidence of dementia: 19%.
    • Incidence rate: 11.8 cases per 1000 person-years.
  • In multivariate analysis using periodontally healthy participants as comparator, risk for dementia was elevated among:
    • Participants with severe periodontal disease (HR, 1.22; 95% CI, 1.01-1.47).
    • Participants with edentulism (HR, 1.26; 95% CI, 1.02-1.54).
  • Findings were similar when considering competing risk for death.
  • Results were much the same for combined outcome of dementia or MCI:
    • Participants with mild/intermediate periodontal disease: risk ratio (RR): 1.22 (1.00-1.48).
    • Participants with edentulism: RR, 1.90 (1.40-2.58).
  • Association was stronger among participants younger than 62 years (P for interaction=.02).

Study design

  • US multicenter, community-based longitudinal cohort study of 8275 adults with baseline mean age of 63 years (Atherosclerosis Risk in Communities Study).
  • Main outcomes: dementia, MCI.
  • Funding: National Heart, Lung, and Blood Institute.

Limitations

  • Cognitive decline may have preceded periodontal disease.
  • Disease status possibly changed over time.
  • Findings may have been weakened by attrition.