PERIODONTITIS AS A RISK FACTOR FOR DEMENTIA: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Introduction: The association between periodontitis and dementia remains controversial. Therefore, we analyzed this association focusing on the severity of periodontitis and type of dementia.

Methods: We searched the PubMed, Embase, Web of Science, and gray literature (OpenGrey, ProQuest) databases from inception to June 30, 2021, and pooled the data for meta-analysis. Fixed- or random-effects models were employed to calculate odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) to evaluate the strength of the associations between periodontitis and dementia.

Results: Thirteen case-control and 11 cohort studies were selected. The analysis of entire studies indicated an association between periodontitis and dementia, with an OR of 2.26 (95% CI, 1.65-3.09; P < .0001) and HR of 1.15 (95% CI, 1.04-1.27; P = .0006). According to periodontitis severity, the risk of dementia was significantly associated with severe periodontitis (OR = 2.85; 95% CI, 2.16-3.74; P = .038), but not with less-than-moderate periodontitis (OR = 0.94; 95% CI, 0.64-1.40; P = .66). In particular, patients with severe periodontitis had a 6.87-fold higher risk of Alzheimer's dementia (OR = 6.87; 95% CI, 2.55-18.54; P = .04) and 2.92-fold higher risk of cognitive impairment (OR = 2.92, 95% CI, 2.15-3.96; P = .36).

Conclusions: We found a strong association between periodontitis and dementia, with severe periodontitis identified as a potential risk factor for Alzheimer's dementia. Therefore, timely management of periodontitis to prevent its progression may help prevent dementia.

Keywords: Dementia; Meta-analysis; Periodontitis; Systematic review.