Systematic Review of the Association Between Periodontitis and Cognitive Impairment in Care Dependent Older Adults

Objectives: This review aimed to identify relationships between periodontitis and cognitive impairment in care dependent older adults.
Methods: Systematic literature searches were performed using six electronic databases to identify studies reporting on older adults who had been clinically diagnosed with periodontitis and cognitive impairment and were dependent on others for care. The association between periodontitis and cognitive impairment was qualitatively assessed.
Results: A total of 434 studies were identified in the search. After duplicates were removed, 270 studies remained. Title, abstract and full text screening was performed by 3 independent reviewers. After applying the eligibility criteria, 6 studies were included in the final review.

The results showed that older individuals with cognitive impairment or dementia had significantly higher mean community periodontal screening scores (CPITN) when compared to those with no evidence of cognitive impairment. Severe periodontitis was diagnosed in 66% of patients with cognitive impairment. Care dependent older adults were significantly more likely to be diagnosed with severe periodontitis (Odds Ratio: 2.9) compared to those without cognitive impairment.
Conclusions: High quality evidence examining this topic is limited. The results of this systematic review suggest a possible link between severe periodontitis and cognitive impairment in care dependent older adults. However, it was not possible to determine the direction of this association from the studies examined.