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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III</title><author><name sortKey="Noble, J M" sort="Noble, J M" uniqKey="Noble J" first="J M" last="Noble">J M Noble</name><affiliation><nlm:aff id="A1">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</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Harlem Hospital Center, Columbia University, College of Physicians and Surgeons, New York, New York, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Borrell, L N" sort="Borrell, L N" uniqKey="Borrell L" first="L N" last="Borrell">L N Borrell</name><affiliation><nlm:aff id="A4">Department of Health Sciences, Lehman College, City University of New York, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Papapanou, P N" sort="Papapanou, P N" uniqKey="Papapanou P" first="P N" last="Papapanou">P N Papapanou</name><affiliation><nlm:aff id="A5">College of Dental Medicine, Section of Oral and Diagnostic Sciences, Division of Periodontics, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Elkind, M S V" sort="Elkind, M S V" uniqKey="Elkind M" first="M S V" last="Elkind">M S V. Elkind</name><affiliation><nlm:aff id="A3">Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Stroke Division, Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Scarmeas, N" sort="Scarmeas, N" uniqKey="Scarmeas N" first="N" last="Scarmeas">N. Scarmeas</name><affiliation><nlm:aff id="A1">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</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Wright, C B" sort="Wright, C B" uniqKey="Wright C" first="C B" last="Wright">C B Wright</name><affiliation><nlm:aff id="A7">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</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">19419981</idno><idno type="pmc">3073380</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3073380</idno><idno type="RBID">PMC:3073380</idno><idno type="doi">10.1136/jnnp.2009.174029</idno><date when="2009">2009</date><idno type="wicri:Area/Pmc/Corpus">002101</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002101</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III</title><author><name sortKey="Noble, J M" sort="Noble, J M" uniqKey="Noble J" first="J M" last="Noble">J M Noble</name><affiliation><nlm:aff id="A1">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</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Harlem Hospital Center, Columbia University, College of Physicians and Surgeons, New York, New York, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Borrell, L N" sort="Borrell, L N" uniqKey="Borrell L" first="L N" last="Borrell">L N Borrell</name><affiliation><nlm:aff id="A4">Department of Health Sciences, Lehman College, City University of New York, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Papapanou, P N" sort="Papapanou, P N" uniqKey="Papapanou P" first="P N" last="Papapanou">P N Papapanou</name><affiliation><nlm:aff id="A5">College of Dental Medicine, Section of Oral and Diagnostic Sciences, Division of Periodontics, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Elkind, M S V" sort="Elkind, M S V" uniqKey="Elkind M" first="M S V" last="Elkind">M S V. Elkind</name><affiliation><nlm:aff id="A3">Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation><affiliation><nlm:aff id="A6">Stroke Division, Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Scarmeas, N" sort="Scarmeas, N" uniqKey="Scarmeas N" first="N" last="Scarmeas">N. Scarmeas</name><affiliation><nlm:aff id="A1">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</nlm:aff></affiliation><affiliation><nlm:aff id="A3">Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA</nlm:aff></affiliation></author><author><name sortKey="Wright, C B" sort="Wright, C B" uniqKey="Wright C" first="C B" last="Wright">C B Wright</name><affiliation><nlm:aff id="A7">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</nlm:aff></affiliation></author></analytic><series><title level="j">Journal of neurology, neurosurgery, and psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><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></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">2985191R</journal-id><journal-id journal-id-type="pubmed-jr-id">5009</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-title>Journal of neurology, neurosurgery, and psychiatry</journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn></journal-meta><article-meta><article-id pub-id-type="pmid">19419981</article-id><article-id pub-id-type="pmc">3073380</article-id><article-id pub-id-type="doi">10.1136/jnnp.2009.174029</article-id><article-id pub-id-type="manuscript">NIHMS274622</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><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
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