title: Longitudinal relationship of severe periodontitis with cognitive decline in older Japanese.
abstract: OBJECTIVE
  Epidemiologic data examining the longitudinal relationship between periodontitis and cognitive status are very limited, especially in Asian populations. The present study examined the longitudinal relationship of periodontitis with cognitive decline in 85 Japanese community-dwelling individuals (average age: 79.3 years) for whom data were available from comprehensive health examinations conducted in 2010 and 2013.
  
  
  METHODS
  Based on a baseline full-mouth periodontal examination, severe periodontitis was defined using a Centers for Disease Control and Prevention/American Academy of Periodontology definition. Cognitive decline during the 3-year study period was defined using the results of the Mini-Mental State Examination (MMSE). Information on age, gender, education, depression, body mass index, smoking status, alcohol use, exercise, hypertension, diabetes, history of cardiovascular disease and stroke, and baseline MMSE scores were obtained and tested as potential confounders in the statistical models.
  
  
  RESULTS
  Among 85 study participants, 21 (24.7%) were defined as having severe periodontitis. Multivariable Poisson regression analyses revealed that severe periodontitis was significantly associated with an increased risk of cognitive decline [adjusted relative risk = 2.2; 95% confidence interval (95% CI): 1.1-4.5]. Furthermore, multivariable linear regression analyses revealed that participants with severe periodontitis had a 1.8-point greater decrease (95% CI: -3.3 to -0.2) in MMSE score than those without severe periodontitis.
  
  
  CONCLUSIONS
  Within the limitations related to its small sample size, the findings of the present study suggest that severe periodontitis is significantly associated with future decline in cognitive function among community-dwelling older Japanese subjects.
authors.affiliation: Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.|Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Iwasaki
authors.affiliation: Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Yoshihara
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Sato
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Wada
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Sakamoto
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ishimoto
authors.affiliation: Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan.
authors.forename: E
authors.initials: E
authors.lastname: Fukutomi
authors.affiliation: Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan.
authors.forename: W
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Imai
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Okumiya
authors.affiliation: Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, CA, USA.
authors.forename: G W
authors.initials: GW
authors.lastname: Taylor
authors.affiliation: Division of Community Oral Health Development, Kyushu Dental University, Kitakyushu, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ansai
authors.affiliation: Division of Preventive Dentistry, Department of Oral Health Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Miyazaki
authors.affiliation: Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan.|Department of Field Medicine, School of Public Health, Kyoto University, Kyoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Matsubayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D044466:Asian People; D015992:Body Mass Index; D002318:Cardiovascular Diseases; D060825:Cognitive Dysfunction / Q000150:complications* / Q000453:epidemiology; D003863:Depression; D004493:Education; D005260:Female; D015438:Health Behavior; D006801:Humans; D006973:Hypertension; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D010518:Periodontitis / Q000150:complications* / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking; D012959:Socioeconomic Factors
keywords: aged; cognitive disorders; longitudinal studies; periodontal diseases