Periodontitis as a Modifiable Risk Factor for Dementia: A Nationwide Population-Based Cohort Study
Periodontitis as a Modifiable Risk Factor for Dementia: A Nationwide Population-Based Cohort Study
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DOI：
10.1111/jgs.14449
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发表时间：
2017-02-01
影响因子：
6.3
通讯作者：
Chen, Chu-Chieh
中科院分区：
文献类型：
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作者：
Lee, Yao-Tung;Lee, Hsin-Chien;Chen, Chu-Chieh
目的：确定牙周炎是否是痴呆症的可改变危险因素。设计：前瞻性队列研究。地点：台湾国家健康保险研究数据库。参与者：65 岁及以上患有牙周炎的个体 (n = 3,028) 以及年龄和性别匹配的对照组 (n = 3,028)。测量：将牙周炎个体的年龄和性别进行比较。新发痴呆的发病密度和风险比（HR）的性别匹配对照。牙周炎是根据牙医诊断的国际疾病分类第九版临床修订版 (ICD-9-CM) 代码 523.3-5 定义的。为了确保诊断的有效性，仅纳入那些同时接受抗生素治疗、除洗牙以外的牙周治疗或每年由认证牙医进行两次以上洗牙的患者。痴呆症根据 ICD-9-CM 代码 290.0-290.4、294.1、331.0-331.2 进行定义。结果：在调整混杂因素后，经计算，患有牙周炎的参与者患痴呆症的风险较高（HR = 1.16，95% 置信区间 = 1.01-1.32，P =.03）。结论：牙周炎与患痴呆症的风险增加相关。牙周感染是可以治疗的，因此它可能是痴呆症的一个可改变的危险因素。临床医生必须更加关注这种潜在的关联，以努力开发新的痴呆症预防和治疗策略。
OBJECTIVES: To determine whether periodontitis is a modifiable risk factor for dementia.DESIGN: Prospective cohort study.SETTING: National Health Insurance Research Database in Taiwan.PARTICIPANTS: Individuals aged 65 and older with periodontitis (n = 3,028) and an age- and sex-matched control group (n = 3,028).MEASUREMENTS: Individuals with periodontitis were compared age-and sex-matched controls with for incidence density and hazard ratio (HR) of new-onset dementia. Periodontitis was defined according to International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 523.3-5 diagnosed by dentists. To ensure diagnostic validity, only those who had concurrently received antibiotic therapies, periodontal treatment other than scaling, or scaling more than twice per year performed by certified dentists were included. Dementia was defined according to ICD-9-CM codes 290.0-290.4, 294.1, 331.0-331.2.RESULTS: After adjustment for confounding factors, the risk of developing dementia was calculated to be higher for participants with periodontitis (HR = 1.16, 95% confidence interval = 1.01-1.32, P =.03) than for those without.CONCLUSION: Periodontitis is associated with greater risk of developing dementia. Periodontal infection is treatable, so it might be a modifiable risk factor for dementia. Clinicians must devote greater attention to this potential association in an effort to develop new preventive and therapeutic strategies for dementia.