Healthy Dietary Pattern Improves Cognitive Function in Elderly Persons With Periodontitis: A Cross-Sectional Study of NHANES

Abstract

Aim

Cognitive decline is thought to be more prevalent in elderly persons with periodontitis. Greater adherence to Healthy Eating Index (HEI)-2015 has been reported to improve cognitive function in the elderly population. However, whether the benefits of HEI-2015 on cognitive function apply to elderly patients with periodontitis remains unknown.

Methods

This is a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES). The data were extracted from database 2011–2014. Cognitive function was measured through the Consortium to Establish a Registry for Alzheimer's Disease battery for immediate recall (CERAD-WL) and delayed recall (CERAD-DR), Animal Fluency Test (AFT), and Digit Symbol Substitution Test (DSST). The data of HEI-2015 were acquired from 24-hour dietary recalls. Weighted linear regression models were performed to investigate the association between HEI-2015 and cognitive function in elderly patients with periodontitis. The associations were further investigated in subgroups of sex, cardiovascular disease status, and depression status.

Results

A total of 1862 participants were included, and 1223 of them had periodontitis. Periodontitis was negatively associated with cognitive function (β = −0.45; 95% confidence interval [CI], −0.87 to −0.03). No statistically significant relationship was observed between HEI-2015 and cognitive function (β = 0.33; 95% CI, −0.02 to 0.69). Low HEI-2015 score was associated with high odds of cognitive decline in patients with periodontitis (β = −0.73; 95% CI, −1.25 to −0.21; P for trend = .01). Higher HEI-2015 was related to the lower incidence of cognitive function decline in patients with periodontitis who were female (β = −0.53; 95% CI, −1.03 to −0.03), had a socioeconomic status from 0 to 3 (β = −0.55; 95% CI, −1.00 to −0.09), did not have cardiovascular disease (β = −0.60; 95% CI, −1.14 to −0.05), and did not have depression (β = −0.57; 95% CI, −1.11 to −0.03).

Conclusions

Greater HEI-2015 adherence may improve cognitive function amongst elderly patients with periodontitis. Further studies are needed to investigate this putative association in elderly persons with periodontitis.