Objectives: This study aimed to determine the association of periodontitis with cognitive impairment by evaluating periodontal conditions in middle-aged and elderly people of normal cognition and cognitive impairment.
Methods: Forty patients with cognitive impairment and thirty-five healthy controls were included in this study. Mini-mental state examination (MMSE) was used to evaluate the level of cognitive function in all patients and controls. Periodontal conditions including severity of periodontitis, number of remaining teeth, percentage of bleeding on probing, probing depth (PD), and attachment level (AL) were examined. Periodontal conditions were compared between patients and controls, and the correlation between periodontal conditions and cognitive-function level was analyzed. Statistical analysis was performed with SPSS 26.0.
Results: The distribution of severity of periodontitis significantly differed between patients and controls (χ2=13.309 and P=0.001). The proportion of severe periodontitis in the cognitive-impairment group was significantly higher than that in the healthy controls (P<0.05). The percentage of sites with PD≥6 mm and AL≥5 mm in the cognitive-impairment group was higher than that in the controls, whereas the percentage of sites with PD=1-3 mm and AL=0-2 mm was higher in the controls (P<0.05). No significant difference in percentage of bleeding on probing was found in the two groups (P>0.05). Patients with cognitive impairment had fewer teeth than the controls (P<0.05). The level of cognitive function, assessed by MMSE, was positively correlated with the number of teeth and the percentage of sites with AL=0-2 mm, and it was negatively correlated with the percentage of sites with AL≥5 mm (P<0.05).
Conclusions: A correlation existed between periodontitis and cognitive impairment. Further study is essential to explore the specific relationship and related mechanism between periodontitis and cognitive impairment.
目的: 通过评估认知功能正常和认知功能障碍中老年人的牙周状况，来研究牙周炎与认知功能障碍之间的关系。方法: 选取认知功能障碍患者40例及认知功能正常的健康对照的中老年人35例，使用简易精神状态量表（MMSE）评估认知功能，并检查和评估其牙周健康状况，包括牙周炎的严重程度、余留牙齿数量、探诊出血阳性率、探诊深度（PD）以及附着水平（AL）。比较两组患者的牙周状况，分析牙周检查指标和认知功能的相关性。使用SPSS 26.0软件进行统计学分析。结果: 认知功能障碍组与健康对照组在牙周炎严重程度的分布情况有明显差异（χ2=13.309，P=0.001），认知功能障碍组的重度牙周炎比例显著高于健康对照组（P<0.05）。认知障碍组PD≥6 mm、AL≥5 mm的位点百分比显著高于对照组，PD=1~3 mm、AL=0~2 mm的位点百分比明显少于对照组（P<0.05）。两组的探诊出血阳性率无明显差别（P>0.05），认知功能障碍组的余留牙齿数量明显少于对照组（P<0.05）。认知功能的MMSE评分与牙齿数量、AL=0~2 mm的位点百分比呈正相关，与AL≥5 mm的位点百分比呈负相关（P<0.05）。结论: 牙周炎与认知功能障碍之间存在相关性，二者之间的具体关系及相关机制值得进一步探究。.
Keywords: cognitive impairment; number of teeth; periodontitis; risk factor; tooth loss.