title: Tooth loss and cognitive impairment.
abstract: OBJECTIVE
  Chronic subclinical inflammation may elevate the risk of cognitive impairment. Periodontitis is associated with subclinical inflammation and accounts in part for tooth loss. The hypothesis was tested that periodontitis and tooth loss as a proxy of chronic periodontitis is associated with cognitive impairment in the elderly.
  
  
  METHODS
  The population-based Study of Health in Pomerania comprises 1336 subjects (60-79 years). Cognitive impairment was assessed with the Mini-Mental Status Examination (MMSE). Tobit regression analyses were adjusted for potential confounders.
  
  
  RESULTS
  A decreased number of teeth was associated with lower MMSE scores in females (p<0.001) and males (p=0.007) in age-adjusted models. In the fully adjusted models, tooth loss was associated with cognitive impairment in females (p=0.002) but not in males (p=0.825).
  
  
  CONCLUSIONS
  A significant association between tooth loss and cognitive impairment was found in females that was not accounted for by potential confounders. Former periodontitis may account for this association as periodontitis was frequently the cause for tooth extractions.
authors.affiliation: Department of Psychiatry and Psychotherapy, HANSE-Klinikum Stralsund, Ernst-Moritz-Arndt-University of Greifswald, Stralsund, Germany. grabeh@uni-greifswald.de
authors.forename: Hans Joergen
authors.initials: HJ
authors.lastname: Grabe
authors.forename: Christian
authors.initials: C
authors.lastname: Schwahn
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Carsten
authors.initials: C
authors.lastname: Spitzer
authors.forename: Harald Juergen
authors.initials: HJ
authors.lastname: Freyberger
authors.forename: Ulrich
authors.initials: U
authors.lastname: John
authors.forename: Thorsten
authors.initials: T
authors.lastname: Mundt
authors.forename: Reiner
authors.initials: R
authors.lastname: Biffar
authors.forename: Thomas
authors.initials: T
authors.lastname: Kocher
mesh_terms: D000368:Aged; D015984:Causality; D016009:Chi-Square Distribution; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D010518:Periodontitis / Q000453:epidemiology*; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D016388:Tooth Loss / Q000453:epidemiology*