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Review
. 2021 Jun 25;18(13):6823.
doi: 10.3390/ijerph18136823.

The Effect of Periodontitis on Dementia and Cognitive Impairment: A Meta-Analysis

Haiying Guo  1 , Shuli Chang  1 , Xiaoqin Pi  1 , Fang Hua  1   2 , Han Jiang  1 , Chang Liu  1 , Minquan Du  1
Affiliations
Review

The Effect of Periodontitis on Dementia and Cognitive Impairment: A Meta-Analysis

Haiying Guo et al. Int J Environ Res Public Health. .

Abstract

The association between periodontal disease and dementia/cognitive impairment continues to receive increasing attention. However, whether periodontal disease is a risk factor for dementia/cognitive impairment is still uncertain. This meta-analysis was conducted to comprehensively analyze the effect of periodontitis on dementia and cognitive impairment, and to assess the periodontal status of dementia patients at the same time. A literature search was undertaken on 19 October 2020 using PubMed, Web of Science, and Embase with different search terms. Two evaluators screened studies according to inclusion and exclusion criteria, and a third evaluator was involved if there were disagreements; this process was the same as that used for data extraction. Included studies were assessed with the Newcastle-Ottawa Scale (NOS), and results were analyzed using software Review Manager 5.2. Twenty observational studies were included. In the comparison between periodontitis and cognitive impairment, the odds ratio (OR) was 1.77 (95% confidence interval (CI), 1.31-2.38), which indicated that there was a strong relationship between periodontitis and cognitive impairment. There was no statistical significance in the effect of periodontitis on dementia (OR = 1.59; 95%CI, 0.92-2.76). The subgroup analysis revealed that moderate or severe periodontitis was significantly associated with dementia (OR = 2.13; 95%CI, 1.25-3.64). The mean difference (MD) of the community periodontal index (CPI) and clinical attachment level (CAL) was 0.25 (95%CI, 0.09-0.40) and 1.22 (95%CI, 0.61-1.83), respectively. In this meta-analysis, there was an association between periodontitis and cognitive impairment, and moderate or severe periodontitis was a risk factor for dementia. Additionally, the deterioration of periodontal status was observed among dementia patients.

Keywords: cognitive impairment; dementia; meta-analysis; periodontal disease; periodontitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Risk of bias summary (a) and risk of bias graph (b) for included studies, respectively.
Figure 3
Figure 3
Forest plot of association between cognitive impairment and periodontitis.
Figure 4
Figure 4
Funnel Plot (a) and forest plot (b) of the relationship between dementia and periodontitis.
Figure 5
Figure 5
Forest plot of periodontal status in dementia patients (a). GI; (b). PI; (c). BOP; (d). GBI; (e). CPI; (f). CAL; (g). PPD.
See this image and copyright information in PMC

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