Midlife Periodontal Disease and Cognitive Functioning: Evidence from High School and Beyond

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's & Dementia Pub Date : 2025-01-09 DOI:10.1002/alz.088355

John Robert Warren, Ryan Demmer, Eric Grodsky, Chandra Muller

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Abstract

Background

Periodontal disease is a prevalent, preventable, and highly treatable oral infection that is (1) stratified by sociodemographic, educational, and spatial factors and (2) is believed to impact cognitive impairment and ADRD risk. However, there is very little information from community-based, population-representative, longitudinal studies about the association between periodontal disease and midlife cognitive functioning net of early life confounders.

Method

We use data from the U.S. High School and Beyond (HSB) cohort study, which has followed a nationally representative sample of ∼25,500 people from high school in 1980 through midlife in 2021-22. HSB data from the 1980s includes rich information about educational contexts, opportunities, and outcomes; early life socioeconomic and family circumstances; spatial location; and demographic group memberships. HSB data from 2021-22 include indicators of periodontal disease diagnosis and multiple measures of cognitive functioning.

Result

People who have been diagnosed with periodontal disease score worse on measures of memory, executive function, and other domains of cognitive functioning at midlife. These associations are only partly attributable to early life confounders. Some ─ but not all ─ of the association can be attributed to the mediating role of diabetes and CVD.

Conclusion

Periodontal disease is a preventable and treatable risk factor for subsequent cognitive impairment. Because risk of periodontal disease is stratified by demographic, educational, and other social factors, periodontal disease may also be important in shaping sociodemographic gradients in midlife cognitive functioning. This is the first population-representative study using data from a community-based cohort that has been followed from adolescence through midlife. As such, this work provides important evidence about the role of periodontal disease in stratifying cognitive outcomes.

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中年牙周病和认知功能：来自高中及以后的证据

牙周病是一种流行的、可预防的、高度可治疗的口腔感染，它(1)受社会人口统计学、教育和空间因素的影响；(2)被认为会影响认知障碍和ADRD的风险。然而，基于社区的、具有人群代表性的、关于牙周病与中年认知功能之间关系的纵向研究，以及早期生活混杂因素的信息很少。方法：我们使用来自美国高中及以上（HSB）队列研究的数据，该研究跟踪了一个具有全国代表性的样本，约25,500人，从1980年的高中到2021 - 22年的中年。20世纪80年代的HSB数据包含有关教育背景、机会和结果的丰富信息；早期生活的社会经济和家庭环境；空间位置;以及人口群体成员。从2021年至2022年的HSB数据包括牙周病诊断指标和认知功能的多项测量。结果被诊断患有牙周病的人在中年时的记忆力、执行功能和其他认知功能方面得分更低。这些关联只能部分归因于早期生活的混杂因素。部分（但不是全部）关联可归因于糖尿病和心血管疾病的中介作用。结论牙周病是可预防、可治疗的认知功能障碍危险因素。由于牙周病的风险是由人口、教育和其他社会因素分层的，牙周病在形成中年认知功能的社会人口梯度方面也可能是重要的。这是第一个使用基于社区的队列数据的人口代表性研究，该队列从青春期一直跟踪到中年。因此，这项工作为牙周病在认知结果分层中的作用提供了重要证据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.