老年人牙周炎与认知障碍之间的关系：国家健康和营养检查调查的横断面研究

IF 1.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology and Global Health Pub Date : 2025-05-01 DOI:10.1016/j.cegh.2025.102020

Qiyin Sun, Mianxiang Li

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引用次数: 0

摘要

目的牙周炎被假设为认知能力下降的一个可改变的危险因素，但基于人群的证据仍然有限。这项研究调查了美国60岁以上老年人牙周炎和认知障碍之间的关系。方法采用2011-2014年全国健康与营养检查调查（NHANES）为基础进行横断面研究。确定牙周炎病例并将其分类为无/轻度或中度/重度。认知功能通过三个问卷调查进行评估：阿尔茨海默病单词学习子测试（CERAD-WL）、动物流畅性测试（AFT）和数字符号替代测试（DSST）。得分低于最低四分位数表明认知障碍。采用二元logistic回归方法探讨60岁以上老年人牙周炎状况与认知功能障碍的关系。结果52.6%（2514例）的患者有中、重度牙周炎。在CERAD-WL和DSST中，中度/重度牙周炎组的中位评分均高于无/轻度牙周炎组（P = 0.046,P = 0.010）。Logistic回归模型显示，未调整模型中重度牙周炎组DSST的比值比为1.605 (95% CI: 1.407 ~ 1.898, P = 0.013)，模型2混杂人口统计学变量的比值比为1.288 (95% CI:1.022 ~ 1.624, P = 0.032)，模型3混杂所有协变量的比值比为1.290 （95% CI: 1.021 ~ 1.630, P = 0.033）。此外，中度/重度牙周炎与性别、贫困收入比（PIR）和牙科就诊频率等因素显著相关。结论：本研究在具有全国代表性的美国60岁及以上老年人中揭示了牙周炎与认知障碍之间的显著关联。

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Association between periodontitis and cognitive impairment in older adults: A cross-sectional study of the National Health and Nutrition Examination Survey

Objectives

Periodontitis has been hypothesized as a modifiable risk factor for cognitive decline, yet population-based evidence remains limited. This study examined the relationship between periodontitis and cognitive impairment among the US seniors over 60.

Methods

This is a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Periodontitis cases were identified and categorized as either none/mild or moderate/severe. Cognitive function was assessed using three questionnaire survey: the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Scores below the lowest quartile indicated cognitive impairment. A binary logistic regression was conducted to explore the relationship between periodontitis status and cognitive impairment in individuals over 60 years old.

Results

The findings indicated that 52.6 % of the sample (n = 2514) had moderate/severe periodontitis. In both CERAD-WL and DSST, the median score in the moderate/severe periodontitis cohort was high than that in the no/mild periodontitis cohort (P = .046,P = .010,respectively). Logistic regression model revealed an odds ratio of 1.605 (95 %CI: 1.407–1.898, P = .013) in DSST for the moderate/severe periodontitis group in unadjusted model, 1.288 (95 % CI:1.022–1.624, P = .032) in model 2 confounding demographic variables, and 1.290 (95 %CI: 1.021–1.630, P = .033) in model 3 confounding all covariants. Furthermore, the moderate/severe periodontitis is significantly associated with several factors: gender, the poverty income ratio(PIR) and dental visit frequency.

Conclusion

This study reveals a significant association between periodontitis and cognitive impairment among US seniors aged 60 and above in a nationally representative sample.

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来源期刊

Clinical Epidemiology and Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

4.60

自引率

7.70%

发文量

218

审稿时长

66 days

期刊介绍： Clinical Epidemiology and Global Health (CEGH) is a multidisciplinary journal and it is published four times (March, June, September, December) a year. The mandate of CEGH is to promote articles on clinical epidemiology with focus on developing countries in the context of global health. We also accept articles from other countries. It publishes original research work across all disciplines of medicine and allied sciences, related to clinical epidemiology and global health. The journal publishes Original articles, Review articles, Evidence Summaries, Letters to the Editor. All articles published in CEGH are peer-reviewed and published online for immediate access and citation.