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Tooth loss, periodontal disease, and cognitive decline in the Atherosclerosis Risk in Communities (ARIC) study.

TitleTooth loss, periodontal disease, and cognitive decline in the Atherosclerosis Risk in Communities (ARIC) study.
Publication TypeJournal Article
Year of Publication2015
AuthorsNaorungroj S, Schoenbach VJ, Wruck L, Mosley TH, Gottesman RF, Alonso A, Heiss G, Beck J
Secondary AuthorsSlade GD
JournalCommunity Dent Oral Epidemiol
Volume43
Issue1
Pagination47-57
Date Published2015 Feb
ISSN1600-0528
KeywordsAged, Cognition Disorders, Coronary Artery Disease, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Mississippi, Periodontal Diseases, Prospective Studies, Tooth Loss
Abstract

OBJECTIVE: The purpose of this prospective study was to investigate whether poor oral health predicted 8-year cognitive function change in predominantly late middle adults in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: Participants included a subset of ARIC participants aged 52-75 years at 1996-1998 from two study sites: Forsyth County NC and Jackson MS. All subjects completed cognitive function assessments both in 1996-1998 and 2004-2006, and the same subjects received a dental examination at the initial visit. Cognitive assessment consisted of delayed word recall (DWR), digit symbol substitution (DSS), and word fluency (WF) tests. In the analysis, cognitive function for 911 dentally screened participants was evaluated, and 558 of 785 dentate participants received comprehensive oral examinations, including periodontal probing. Measures of oral health included dental status, number of teeth, and periodontal disease classified by the biofilm-gingival interface (BGI) index. The generalized estimating equations (GEE) method was used to analyze repeated measures of cognitive scores with adjustment for socio-demographic characteristics and cardiovascular risk factors.

RESULTS: Of 911 study participants, 13.8% were edentulous. About 13% of dentally examined participants had periodontal pockets (≥ 4 mm) with severe bleeding. At the follow-up visit, DWR and WF scores were lower in edentulous compared to dentate people, whereas other oral health measures were not associated with cognitive function. Mean values declined over time for all three cognitive measures, although poor oral health conditions were not associated with greater degree of decline in cognitive function.

CONCLUSIONS: In these late middle-aged adults, complete tooth loss was significantly associated with lower cognitive performance. However, neither edentulism, number of teeth, nor periodontal disease predicted greater subsequent cognitive decline.

DOI10.1111/cdoe.12128
Alternate JournalCommunity Dent Oral Epidemiol
PubMed ID25363061
PubMed Central IDPMC4303516
Grant ListN01HC55020 / HL / NHLBI NIH HHS / United States
R01 DE011551 / DE / NIDCR NIH HHS / United States
N01HC55018 / HL / NHLBI NIH HHS / United States
N01-HC55015 / HC / NHLBI NIH HHS / United States
N01-HC 55022 / HC / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
N01HC55022 / HL / NHLBI NIH HHS / United States
N01HC55015 / HL / NHLBI NIH HHS / United States
N01-HC 55021 / HC / NHLBI NIH HHS / United States
R01-HL70825 / HL / NHLBI NIH HHS / United States
N01-HC 55018 / HC / NHLBI NIH HHS / United States
DE 13807-01A1 / DE / NIDCR NIH HHS / United States
N01HC55016 / HL / NHLBI NIH HHS / United States
N01-HC 55020 / HC / NHLBI NIH HHS / United States
N01 HC055015 / HC / NHLBI NIH HHS / United States
N01HC55019 / HL / NHLBI NIH HHS / United States
R01 HL070825 / HL / NHLBI NIH HHS / United States
N01-HC 55016 / HC / NHLBI NIH HHS / United States
N01HC55021 / HL / NHLBI NIH HHS / United States
N01-HC 55019 / HC / NHLBI NIH HHS / United States