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Association between Periodontal Disease and Cognitive Impairment in Adults
Said-Sadier N, Sayegh B, Farah R, Abbas LA, Dweik R, Tang N, Ojcius DM.. International journal of environmental research and public health, 2023-03-07
Topic: Risk, prevention and care in population studies
Introduction Periodontitis is a severe oral infection that can contribute to systemic inflammation. A large body of evidence suggests a role for systemic inflammation in the initiation of neurodegenerative disease. This systematic review synthesized data from observational studies to investigate the association between periodontitis and neuroinflammation in adults. Methods and materials A systematic literature search of PubMed, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for studies published from the date of inception up to September 2021. Search terms for the exposure "oral disease" and outcome "dementia", "neuroinflammation" and "cognitive decline" were used. Study selection and data extraction were independently undertaken by two reviewers. The final eligible articles were included only if the exposure is periodontitis and the outcome is cognitive impairment or dementia or a topic related to this condition, and if the study was conducted in an adult population. The quality and risk of bias were assessed by Newcastle Ottawa Scale (NOS). Qualitative synthesis was used to narratively synthesize the results. Six cohort studies, three cross-sectional studies, and two case-control studies met the inclusion criteria. These eleven studies were only narratively synthesized. Meta-analysis was not performed due to the methodological heterogeneity of the studies. Results The results of included studies show that chronic periodontitis patients with at least eight years of exposure are at higher risk of developing cognitive decline and dementia. Oral health measures such as gingival inflammation, attachment loss, probing depth, bleeding on probing, and alveolar bone loss are associated with cognitive impairment. The reduction of epidermal growth factor (EGF), interleukin 8 (IL-8), interferon γ-induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) in addition to over expression of interleukin 1-β (IL-1β) are significant in patients suffering from cognitive decline with pre-existing severe periodontitis. Conclusions All the included studies show evidence of an association between periodontitis and cognitive impairment or dementia and Alzheimer's disease pathology. Nonetheless, the mechanisms responsible for the association between periodontitis and dementia are still unclear and warrant further investigation.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Said-Sadier, N., Sayegh, B., Farah, R., Abbas, L. A., Dweik, R., Tang, N., et al. (2023). Association between Periodontal Disease and Cognitive Impairment in Adults. International journal of environmental research and public health. https://doi.org/10.3390/ijerph20064707
Vancouver
Said-Sadier N, Sayegh B, Farah R, Abbas LA, Dweik R, Tang N, et al. Association between Periodontal Disease and Cognitive Impairment in Adults. International journal of environmental research and public health. 2023. doi:10.3390/ijerph20064707. PMID: 36981618.
BibTeX
@article{saidsadier2023-36981618,
author = {Said-Sadier, N. and Sayegh, B. and Farah, R. and Abbas, L. A. and Dweik, R. and Tang, N. and Ojcius, D. M.},
title = {{Association between Periodontal Disease and Cognitive Impairment in Adults}},
journal = {International journal of environmental research and public health},
year = {2023},
doi = {10.3390/ijerph20064707},
pmid = {36981618},
url = {https://doi.org/10.3390/ijerph20064707}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Qualitative synthesis was used to narratively synthesize the results.
- Results The results of included studies show that chronic periodontitis patients with at least eight years of exposure are at higher risk of developing cognitive decline and dementia.
- Oral health measures such as gingival inflammation, attachment loss, probing depth, bleeding on probing, and alveolar bone loss are associated with cognitive impairment.
- The reduction of epidermal growth factor (EGF), interleukin 8 (IL-8), interferon γ-induced protein 10 (IP-10), and monocyte chemoattractant protein-1 (MCP-1) in addition to over expression of interleukin 1-β (IL-1β) are significant in patients suffering from cognitive decline with pre-existing severe periodontitis.
Why it matters
Across eleven observational studies, this review found that people with chronic gum disease (periodontitis) for at least eight years had a higher risk of cognitive decline and dementia, and that signs like gum inflammation and bone loss were associated with cognitive impairment. All included studies supported a link. However, how gum disease might lead to dementia is still unclear, so this shows an association rather than proof that treating gums prevents Alzheimer's.
Study details
- Study designsystematic review
- Evidence strengthHigh
How this study scored 63/100
Published in a peer-reviewed journal, and it is a systematic review of all the studies on the question. Scored zero for sample size, effect reported and studied in people because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International journal of environmental research and public health) |
| Journal's citation record | 3 / 4 | International Journal of Environmental Research and Public Health: journal h-index 320 (OpenAlex, 2026-10-29) |
| Study design | 12 / 12 | A systematic review of all the studies on the question |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2023 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | A review of other studies — randomisation is not credited here |
| Times cited | 4 / 7 | Cited 58 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 11.6 citations a year over 5 year(s) since 2023 |
| Impact for its field and year | 4 / 6 | Cited 13.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 3 / 4 | Cited 53 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author David M. Ojcius: h-index 85 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | San Francisco VA Medical Center: institution h-index 522 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 36981618) |
| Free to read | 2 / 2 | Free to read |
| Total | 63 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.3390/ijerph20064707
- PubMed: 36981618
- Original source →
- Free full text: International Journal of Environmental Research and Public Health →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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