Periodontitis as a Modifiable Risk Factor for Dementia: A Nationwide Population-Based Cohort Study.
OBJECTIVE
To determine whether periodontitis is a modifiable risk factor for dementia.


METHODS
Prospective cohort study.


METHODS
National Health Insurance Research Database in Taiwan.


METHODS
Individuals aged 65 and older with periodontitis (n = 3,028) and an age- and sex-matched control group (n = 3,028).


METHODS
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.


CONCLUSIONS
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.
Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Yao-Tung
YT
Lee
Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Hsin-Chien
HC
Lee
Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Brain and Consciousness Research Center, Taipei Medical University, Taipei City, Taiwan.
Chaur-Jongh
CJ
Hu
Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Brain and Consciousness Research Center, Taipei Medical University, Taipei City, Taiwan.
Li-Kai
LK
Huang
Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Brain and Consciousness Research Center, Taipei Medical University, Taipei City, Taiwan.
Shu-Ping
SP
Chao
Department of Psychiatry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.|Dementia Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
Chia-Pei
CP
Lin
Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei City, Taiwan.
Emily Chia-Yu
EC
Su
Department of Health Administration, Tzu-Chi University of Science and Technology, Hualien, Taiwan.
Yi-Chen
YC
Lee
Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Chu-Chieh
CC
Chen
D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D016208:Databases, Factual; D003704:Dementia / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010518:Periodontitis / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
dementia; modifiable risk factor; nationwide cohort study; periodontitis