Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III
Identifieur interne : 002738 ( Ncbi/Merge ); précédent : 002737; suivant : 002739Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III
Auteurs : J M Noble [États-Unis] ; L N Borrell [États-Unis] ; P N Papapanou [États-Unis] ; M S V. Elkind [États-Unis] ; N. Scarmeas [États-Unis] ; C B Wright [États-Unis]Source :
- Journal of neurology, neurosurgery, and psychiatry [ 0022-3050 ] ; 2009.
Abstract
Periodontitis is ubiquitous and associated with serological evidence of exposure to periodontal organisms, systemic inflammation and vascular disease. Dementia is a major public health problem likely related to a complex interaction between genetics and diseases associated with systemic inflammation, including diabetes, smoking and stroke.
To assess relationships between systemic exposure to periodontal pathogens and cognitive test outcomes, data were analysed from the Third National Health and Nutrition Examination Survey (NHANES-III), a nationally representative cross sectional observational study among older adults. We included 2355 participants ≥60 years who completed measures of cognition and
Poor immediate verbal memory (<5/9 points) was prevalent in 5.7% of patients, and 6.5% overall had impaired delayed recall (<4/9); 22.1% had difficulty with serial subtractions (<5/5 trials correct). Individuals with the highest
A serological marker of periodontitis is associated with impaired delayed memory and calculation. Further exploration of relationships between oral health and cognition is warranted.
Url:
DOI: 10.1136/jnnp.2009.174029
PubMed: 19419981
PubMed Central: 3073380
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Periodontitis is ubiquitous and associated with serological evidence of exposure to periodontal organisms, systemic inflammation and vascular disease. Dementia is a major public health problem likely related to a complex interaction between genetics and diseases associated with systemic inflammation, including diabetes, smoking and stroke.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">To assess relationships between systemic exposure to periodontal pathogens and cognitive test outcomes, data were analysed from the Third National Health and Nutrition Examination Survey (NHANES-III), a nationally representative cross sectional observational study among older adults. We included 2355 participants ≥60 years who completed measures of cognition and <italic>Poryphyromonas gingivalis</italic>
IgG. Using SUDAAN, logistic regression models examined the association of <italic>P gingivalis</italic>
IgG with cognitive test performance.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Poor immediate verbal memory (<5/9 points) was prevalent in 5.7% of patients, and 6.5% overall had impaired delayed recall (<4/9); 22.1% had difficulty with serial subtractions (<5/5 trials correct). Individuals with the highest <italic>P gingivalis</italic>
IgG (>119 ELISA Units (EU)) were more likely to have poor delayed verbal recall (OR 2.89, 95% CI 1.14 to 7.29) and impaired subtraction (OR 1.95, 95% CI 1.22 to 3.11) than those with the lowest (≤57 EU), with dose–response relationships for both (p trend, delayed memory=0.045, subtraction=0.04). After adjusting for socioeconomic and vascular variables, these relationships remained robust for the highest <italic>P gingivalis</italic>
IgG group (delayed verbal memory OR 3.01 (95% CI 1.06 to 8.53); subtraction OR 2.00 (95% CI 1.19 to 3.36)). In contrast, immediate verbal memory was not significantly associated with <italic>P gingivalis</italic>
.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">A serological marker of periodontitis is associated with impaired delayed memory and calculation. Further exploration of relationships between oral health and cognition is warranted.</p>
</sec>
</div>
</front>
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<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
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<title-group><article-title>Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Noble</surname>
<given-names>J M</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Borrell</surname>
<given-names>L N</given-names>
</name>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Papapanou</surname>
<given-names>P N</given-names>
</name>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Elkind</surname>
<given-names>M S V</given-names>
</name>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A6">6</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Scarmeas</surname>
<given-names>N</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Wright</surname>
<given-names>C B</given-names>
</name>
<xref ref-type="aff" rid="A7">7</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Gertrude H Sergievsky Center, Columbia University Medical Center, New York, NY, USA and the Taub Institute on Alzheimer Disease and the Aging Brain, Columbia University Medical Center, New York, New York, USA</aff>
<aff id="A2"><label>2</label>
Harlem Hospital Center, Columbia University, College of Physicians and Surgeons, New York, New York, USA</aff>
<aff id="A3"><label>3</label>
Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</aff>
<aff id="A4"><label>4</label>
Department of Health Sciences, Lehman College, City University of New York, New York, New York, USA</aff>
<aff id="A5"><label>5</label>
College of Dental Medicine, Section of Oral and Diagnostic Sciences, Division of Periodontics, Columbia University Medical Center, New York, New York, USA</aff>
<aff id="A6"><label>6</label>
Stroke Division, Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</aff>
<aff id="A7"><label>7</label>
Evelyn F McKnight Center for Age-related Memory Loss, Division of Cognitive Disorders, Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA</aff>
<author-notes><corresp id="cor1">Correspondence to: Dr J M Noble, Harlem Hospital Center, Columbia College of Physicians and Surgeons, Department of Neurology, 506 Lenox Ave, New York, NY 10037, USA; <email>jn2054@columbia.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>9</day>
<month>3</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>5</day>
<month>5</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><month>11</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>11</day>
<month>4</month>
<year>2011</year>
</pub-date>
<volume>80</volume>
<issue>11</issue>
<fpage>1206</fpage>
<lpage>1211</lpage>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Periodontitis is ubiquitous and associated with serological evidence of exposure to periodontal organisms, systemic inflammation and vascular disease. Dementia is a major public health problem likely related to a complex interaction between genetics and diseases associated with systemic inflammation, including diabetes, smoking and stroke.</p>
</sec>
<sec sec-type="methods" id="S2"><title>Methods</title>
<p id="P2">To assess relationships between systemic exposure to periodontal pathogens and cognitive test outcomes, data were analysed from the Third National Health and Nutrition Examination Survey (NHANES-III), a nationally representative cross sectional observational study among older adults. We included 2355 participants ≥60 years who completed measures of cognition and <italic>Poryphyromonas gingivalis</italic>
IgG. Using SUDAAN, logistic regression models examined the association of <italic>P gingivalis</italic>
IgG with cognitive test performance.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Poor immediate verbal memory (<5/9 points) was prevalent in 5.7% of patients, and 6.5% overall had impaired delayed recall (<4/9); 22.1% had difficulty with serial subtractions (<5/5 trials correct). Individuals with the highest <italic>P gingivalis</italic>
IgG (>119 ELISA Units (EU)) were more likely to have poor delayed verbal recall (OR 2.89, 95% CI 1.14 to 7.29) and impaired subtraction (OR 1.95, 95% CI 1.22 to 3.11) than those with the lowest (≤57 EU), with dose–response relationships for both (p trend, delayed memory=0.045, subtraction=0.04). After adjusting for socioeconomic and vascular variables, these relationships remained robust for the highest <italic>P gingivalis</italic>
IgG group (delayed verbal memory OR 3.01 (95% CI 1.06 to 8.53); subtraction OR 2.00 (95% CI 1.19 to 3.36)). In contrast, immediate verbal memory was not significantly associated with <italic>P gingivalis</italic>
.</p>
</sec>
<sec id="S4"><title>Conclusion</title>
<p id="P4">A serological marker of periodontitis is associated with impaired delayed memory and calculation. Further exploration of relationships between oral health and cognition is warranted.</p>
</sec>
</abstract>
<contract-num rid="NS1">T32 NS007153-23
||NS</contract-num>
<contract-sponsor id="NS1">National Institute of Neurological Disorders and Stroke : NINDS</contract-sponsor>
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<name sortKey="Papapanou, P N" sort="Papapanou, P N" uniqKey="Papapanou P" first="P N" last="Papapanou">P N Papapanou</name>
<name sortKey="Scarmeas, N" sort="Scarmeas, N" uniqKey="Scarmeas N" first="N" last="Scarmeas">N. Scarmeas</name>
<name sortKey="Scarmeas, N" sort="Scarmeas, N" uniqKey="Scarmeas N" first="N" last="Scarmeas">N. Scarmeas</name>
<name sortKey="Wright, C B" sort="Wright, C B" uniqKey="Wright C" first="C B" last="Wright">C B Wright</name>
</country>
</tree>
</affiliations>
</record>
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