Tooth Loss and Periodontal Disease Predict Poor Cognitive Function in Older Men

OBJECTIVES: To determine whether rates of tooth loss, periodontal disease progression, and caries incidence predict cognitive decline in men. DESIGN: Prospective study. SETTING: Community‐dwelling men enrolled in the Veterans Affairs Dental Longitudinal Study. PARTICIPANTS: Five hundred ninety‐seven...

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Published in:	Journal of the American Geriatrics Society (JAGS) Vol. 58; no. 4; pp. 713 - 718
Main Authors:	Kaye, Elizabeth Krall, Valencia, Aileen, Baba, Nivine, Spiro III, Avron, Dietrich, Thomas, Garcia, Raul I.
Format:	Journal Article
Language:	English
Published:	Malden, USA Blackwell Publishing Inc 01-04-2010 Wiley-Blackwell Wiley Subscription Services, Inc
Subjects:	Adult Age Distribution Aged Biological and medical sciences Boston - epidemiology Cognition Disorders - diagnosis Cognition Disorders - epidemiology Cognition Disorders - etiology Cognitive ability cognitive impairment dental caries Dental Caries - complications Dental Caries - diagnosis Dental health Dental Health Surveys Disease Progression Facial bones, jaws, teeth, parodontium: diseases, semeiology General aspects Geriatric Assessment Humans Male Medical sciences Men Mental Status Schedule Middle Aged Mini-Mental State Examination Miscellaneous Non tumoral diseases Older people Otorhinolaryngology. Stomatology periodontal diseases Periodontal Diseases - complications Periodontal Diseases - diagnosis Predictive Value of Tests Proportional Hazards Models Prospective Studies Public health. Hygiene Public health. Hygiene-occupational medicine Risk Factors tooth loss Tooth Loss - complications Tooth Loss - diagnosis Boston Human Mini Mental State Examination Folstein et al Cognitive disorder Stomatology Dental disease Prediction Neuropsychological test Dental carie Male Cognition tooth loss dental caries Gerontology Periodontal disease Bucco-dental health cognitive impairment periodontal diseases Predictive factor Elderly Mini-Mental State Examination Geriatrics
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Summary:	OBJECTIVES: To determine whether rates of tooth loss, periodontal disease progression, and caries incidence predict cognitive decline in men. DESIGN: Prospective study. SETTING: Community‐dwelling men enrolled in the Veterans Affairs Dental Longitudinal Study. PARTICIPANTS: Five hundred ninety‐seven dentate men aged 28 to 70 at study baseline who have been followed up to 32 years. MEASUREMENTS: Oral examinations were conducted approximately every 3 years. Periodontal disease measures included probing pocket depth and radiographic alveolar bone height. Participants underwent cognitive testing beginning in 1993. Low cognitive status was defined as less than 25 points or less than 90% of the age‐ and education‐specific median on the Mini‐Mental State Examination (MMSE) and less than 10 points on a spatial copying task. RESULTS: Each tooth lost per decade since the baseline dental examination increased the risks of low MMSE score (hazard ratio (HR)=1.09, 95% confidence interval (CI)=1.01–1.18) and low spatial copying score (HR=1.12, CI=1.05–1.18). Risks were greater per additional tooth with progression of alveolar bone loss (spatial copying: HR=1.03, CI=1.01–1.06), probing pocket depth (MMSE: HR=1.04, CI=1.01–1.09; spatial copying: HR=1.04, CI=1.01–1.06), and caries (spatial copying: HR=1.05, CI=1.01–1.08). Risks were consistently higher in men who were older than 45.5 at baseline than in younger men. CONCLUSION: Risk of cognitive decline in older men increases as more teeth are lost. Periodontal disease and caries, major reasons for tooth loss, are also related to cognitive decline.
Bibliography:	ArticleID:JGS2788 istex:A2024BDDA9CA75BA0BAA3DA84B89C8ECEB932A37 ark:/67375/WNG-GQH9HMRK-3 Abstracts from this study were presented at the Cognitive Aging Conference 2008 http://iadr.confex.com/iadr/2008Toronto/techprogram/abstract_104698.htm http://www.cos.gatech.edu/cac/program.pdf p. 7) and the International Association for Dental Research, 2008 . ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Article-2 ObjectType-Feature-1
ISSN:	0002-8614 1532-5415
DOI:	10.1111/j.1532-5415.2010.02788.x