title: Adverse oral health and cognitive decline: the health, aging and body composition study.
abstract: OBJECTIVE
  To investigate the relationship between periodontal disease and cognitive decline.
  
  
  METHODS
  Analysis of a prospective cohort study.
  
  
  METHODS
  The Health, Aging and Body Composition (Health ABC) Study.
  
  
  METHODS
  One thousand fifty-three participants who were administered the Modified Mini-Mental State Examination (3MS) at Year 1 (baseline) and Year 3 and had participated in a comprehensive periodontal examination at Year 2.
  
  
  METHODS
  The prospective association between a range of oral health parameters and cognitive function was examined. Decline in 3MS score from Year 3 to 5 was investigated in 947 (89.9%) participants. Covariates included age, sex, education, race, cardiovascular disease and risk, and depressive symptoms.
  
  
  RESULTS
  Most indicators of adverse oral health at Year 2 were associated with cognitive impairment based on averaged 3MS scores less than 80 for Years 1 and 3, but education and race substantially confounded these associations. Higher gingival index, a measure of gingival inflammation, at Year 2 remained independently associated with this definition of cognitive impairment and, in fully adjusted analyses, was also an independent predictor of a more-than-5-point cognitive decline from Year 3 to 5.
  
  
  CONCLUSIONS
  Periodontitis may be a risk factor for cognitive decline. Gingivitis is reversible, and periodontitis to some degree is preventable and controllable when manifest. Therefore, further research is needed to clarify potential underlying mechanisms and oral health interventions that might ameliorate cognitive decline.
authors: King's College London, London (Institute of Psychiatry), UK. r.stewart@iop.kcl.ac.uk
authors: Robert
authors: R
authors: Stewart
authors: Robert J
authors: RJ
authors: Weyant
authors: Melissa E
authors: ME
authors: Garcia
authors: Tamara
authors: T
authors: Harris
authors: Lenore J
authors: LJ
authors: Launer
authors: Suzanne
authors: S
authors: Satterfield
authors: Eleanor M
authors: EM
authors: Simonsick
authors: Kristine
authors: K
authors: Yaffe
authors: Anne B
authors: AB
authors: Newman
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D001823:Body Composition; D003072:Cognition Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D009909:Oral Health; D011446:Prospective Studies; D012307:Risk Factors