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. 2017 Aug 8;9(1):56.
doi: 10.1186/s13195-017-0282-6.

Association between chronic periodontitis and the risk of Alzheimer's disease: a retrospective, population-based, matched-cohort study

Chang-Kai Chen  1   2 , Yung-Tsan Wu  3 , Yu-Chao Chang  4   5
Affiliations

Association between chronic periodontitis and the risk of Alzheimer's disease: a retrospective, population-based, matched-cohort study

Chang-Kai Chen et al. Alzheimers Res Ther. .

Abstract

Background: Although recent short-term cross-sectional studies have revealed that chronic periodontitis (CP) may be a risk factor for increased cognitive impairment in patients with Alzheimer's disease (AD), systematic reviews and long-term longitudinal studies have provided less clear evidence regarding the relationship between CP and AD. Therefore, we conducted a retrospective cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with CP are at increased risk of developing AD.

Methods: We conducted a retrospective matched-cohort study using the NHIRD of Taiwan. We identified 9291 patients newly diagnosed with CP between 1997 and 2004. A total of 18,672 patients without CP were matched to the patient cohort according to sex, age, index year, co-morbidity and urbanisation level. Cox proportional hazards regression analyses were performed to evaluate the subsequent risk of AD.

Results: Patients with CP had a higher prevalence of hyperlipidaemia, depression, traumatic brain injury and co-morbidities, as well as higher urbanisation levels, than those in the unexposed cohort (all p < 0.01). At the final follow-up, totals of 115 (1.24%) and 208 (1.11%) individuals in the CP exposed and unexposed groups, respectively, had developed AD. Patients with 10 years of CP exposure exhibited a higher risk of developing AD than unexposed groups (adjusted HR 1.707, 95% CI 1.152-2.528, p = 0.0077).

Conclusions: Our findings demonstrate that 10-year CP exposure was associated with a 1.707-fold increase in the risk of developing AD. These findings highlight the need to prevent progression of periodontal disease and promote healthcare service at the national level.

Keywords: Alzheimer’s disease; Cohort study; Nationwide population; Periodontitis; Risk factors.

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Conflict of interest statement

Ethics approval and consent to participate

Approval for the present study was obtained from the institutional review board (IRB) of Chung Shan Medical University (CS2-15071). The requirement for informed consent was waived by the IRB because all NHIRD data had been de-identified.

Consent for publication

All authors approved the manuscript for submission.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flowchart of cohort selection of patients from the National Health Insurance Research Database in Taiwan
Fig. 2
Fig. 2
Kaplan-Meier model based on the Cox-regression analysis with the log-rank test for the cumulative risk of Alzheimer’s disease among the exposed and unexposed cohorts
See this image and copyright information in PMC

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