IADR Abstract Archives
Cognitive Impairment With Poor Oral Health Increases the Risk of Mortality
Objectives: Cognitive impairment and poor oral health are frequently seen in frail older persons. Both conditions have been identified as risk factors for mortality. The joint associations of cognitive impairment and poor oral health with mortality among older persons have not been well studied and are therefore the focus of this prospective cohort study.
Methods: Participants from the U.S. National Health and Nutrition Examination Survey who were 60 years or older at baseline (1999–2002) were followed up until 2015. Cognitive function was evaluated by digit symbol substitution test (DSST). Oral health status was assessed based on the presence of untreated caries, moderate/severe periodontitis, and edentulism. The combined effects of caries/periodontitis or edentulism and cognitive impairment on all-cause and cardiometabolic mortality were examined using the Cox proportional hazard models after adjusting for potential confounders.
Results: In total, 1,973 participants were enrolled in the prospective study. At a median follow-up of 13.4 years, 978 participants had died (264 deaths due to cardiometabolic disease). Cognitive impairment, periodontitis, and edentulism were each found to be independent predictors of total mortality. Caries, however, was not found to be significantly related to mortality. When analyzing these independent predictors in combination, a diagnosis of cognitive impairment and periodontitis is associated with an 80.7% increase in all-cause mortality risk (adjusted hazard ratio [HR adjusted] = 1.807, 95% CI: 1.337–2.443) and a 90.2% increase in cardiometabolic mortality risk (HR adjusted = 1.902, 95% CI: 1.070–3.381) compared with healthy controls. Similarly, the risks for all-cause mortality were highest in cases where impaired cognition and edentulism co-occurred (HR adjusted = 1.596, 1.235–2.064).
Conclusions: Concomitant presence of cognitive dysfunction and periodontitis or edentulism can be associated with a higher risk of long-term mortality among community-dwelling older U.S. adults.
Methods: Participants from the U.S. National Health and Nutrition Examination Survey who were 60 years or older at baseline (1999–2002) were followed up until 2015. Cognitive function was evaluated by digit symbol substitution test (DSST). Oral health status was assessed based on the presence of untreated caries, moderate/severe periodontitis, and edentulism. The combined effects of caries/periodontitis or edentulism and cognitive impairment on all-cause and cardiometabolic mortality were examined using the Cox proportional hazard models after adjusting for potential confounders.
Results: In total, 1,973 participants were enrolled in the prospective study. At a median follow-up of 13.4 years, 978 participants had died (264 deaths due to cardiometabolic disease). Cognitive impairment, periodontitis, and edentulism were each found to be independent predictors of total mortality. Caries, however, was not found to be significantly related to mortality. When analyzing these independent predictors in combination, a diagnosis of cognitive impairment and periodontitis is associated with an 80.7% increase in all-cause mortality risk (adjusted hazard ratio [HR adjusted] = 1.807, 95% CI: 1.337–2.443) and a 90.2% increase in cardiometabolic mortality risk (HR adjusted = 1.902, 95% CI: 1.070–3.381) compared with healthy controls. Similarly, the risks for all-cause mortality were highest in cases where impaired cognition and edentulism co-occurred (HR adjusted = 1.596, 1.235–2.064).
Conclusions: Concomitant presence of cognitive dysfunction and periodontitis or edentulism can be associated with a higher risk of long-term mortality among community-dwelling older U.S. adults.
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