Tooth loss and cognitive impairment

Objectives: 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...

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Published inJournal of clinical periodontology Vol. 36; no. 7; pp. 550 - 557
Main Authors Grabe, Hans Joergen, Schwahn, Christian, Völzke, Henry, Spitzer, Carsten, Freyberger, Harald Juergen, John, Ulrich, Mundt, Thorsten, Biffar, Reiner, Kocher, Thomas
Format Journal Article
LanguageEnglish
Published Oxford, UK Blackwell Publishing Ltd 01.07.2009
Blackwell
Subjects
Aged
Biological and medical sciences
Causality
Chi-Square Distribution
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
cognitive impairment
Comorbidity
Cross-Sectional Studies
Facial bones, jaws, teeth, parodontium: diseases, semeiology
Female
general population
Geriatric Assessment
Germany - epidemiology
Humans
Male
Medical sciences
Mental Status Schedule
Non tumoral diseases
Otorhinolaryngology. Stomatology
periodontitis
Periodontitis - epidemiology
Regression Analysis
Sex Factors
Socioeconomic Factors
Statistics, Nonparametric
tooth loss
Tooth Loss - epidemiology
Germany
Periodontal disease
Cognitive disorder
Periodontitis
Stomatology
Teeth
cognitive impairment
Tooth
Dentistry
general population
tooth loss
Online AccessGet full text
ISSN0303-6979
1600-051X
1600-051X
DOI10.1111/j.1600-051X.2009.01426.x

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Abstract Objectives: 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. Subjects and 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.
AbstractList 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. 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. 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). 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.
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.OBJECTIVESChronic 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.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.SUBJECTS AND METHODSThe 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.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).RESULTSA 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).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.CONCLUSIONSA 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.
Grabe HJ, Schwahn C, Voelzke H, Spitzer C, Freyberger HJ, John U, Mundt T, Biffar R, Kocher T. Tooth loss and cognitive impairment. J Clin Periodontol 2009. doi: 10.1111-j.1600-051X.2009.01426.x.AbstractObjectives: 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.Subjects and 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.
Objectives: 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. Subjects and 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.
Objectives: 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. Subjects and 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.
Author Grabe, Hans Joergen
Völzke, Henry
Mundt, Thorsten
Kocher, Thomas
Schwahn, Christian
Biffar, Reiner
Freyberger, Harald Juergen
John, Ulrich
Spitzer, Carsten
Author_xml – sequence: 1
  givenname: Hans Joergen
  surname: Grabe
  fullname: Grabe, Hans Joergen
  organization: Department of Psychiatry and Psychotherapy, HANSE-Klinikum Stralsund, Ernst-Moritz-Arndt-University of Greifswald, Stralsund, Germany
– sequence: 2
  givenname: Christian
  surname: Schwahn
  fullname: Schwahn, Christian
  organization: Center of Oral Health
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  fullname: Völzke, Henry
  organization: Institute for Community Medicine, University of Greifswald, Stralsund, Germany
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  givenname: Carsten
  surname: Spitzer
  fullname: Spitzer, Carsten
  organization: Department of Psychosomatic Medicine and Psychotherapy, University of Hamburg, Hamburg, Germany
– sequence: 5
  givenname: Harald Juergen
  surname: Freyberger
  fullname: Freyberger, Harald Juergen
  organization: Department of Psychiatry and Psychotherapy, HANSE-Klinikum Stralsund, Ernst-Moritz-Arndt-University of Greifswald, Stralsund, Germany
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  givenname: Thorsten
  surname: Mundt
  fullname: Mundt, Thorsten
  organization: Center of Oral Health
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  fullname: Biffar, Reiner
  organization: Center of Oral Health
– sequence: 9
  givenname: Thomas
  surname: Kocher
  fullname: Kocher, Thomas
  organization: Center of Oral Health
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IsPeerReviewed true
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Issue 7
Keywords Periodontal disease
Cognitive disorder
Periodontitis
Stomatology
Teeth
cognitive impairment
Tooth
Dentistry
general population
tooth loss
Language English
License http://onlinelibrary.wiley.com/termsAndConditions#vor
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Community Medicine Research
net of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant no. ZZ9603) and the Federal State of Mecklenburg‐Vorpommern. T. K. was supported by an unrestricted grant from Gaba (Switzerland). The funding sources were not involved in the design and conduct of the study, collection, management, analysis, and interpretation of the data, and the preparation, review and approval of the manuscript.
Conflict of interest and source of funding statement
There is no conflict of interests.
External financial support in the past 3 years:
Hans Joergen Grabe: German Research Foundation; Federal Ministry of Education and Research Germany; speakers honoraria from AstraZeneca and Bristol Myers Squibb, Eli Lilly, Novartis, Eisai, Wyeth and travel funds from Janssen‐Cilag; Eli Lilly, SALUS‐Institute for Trend‐Research and Therapy Evaluation in Mental Health.
Christian Schwahn: Research grants by Federal Ministry of Education and Research Germany, GABA, German Society of Periodontology.
Carsten Spitzer: Travel funds and speakers honoraria from Janssen‐Cilag; research grant from the “Stiftung zur Aufarbeitung der SED‐Diktatur”.
Henry Völzke: Research grants by Sanofi‐Aventis, Biotronik, the Humboldt Foundation, the Federal Ministry of Education and Research (Germany) and the German Research Foundation.
Ulrich John: Research funding by German Research Foundation; European Union, Federal Ministry of Education and Research Germany, Social Ministry of the Federal State of Mecklenburg‐West Pomerania of Germany.
Harald J. Freyberger: German Research Foundation; Social Ministry of the Federal State of Mecklenburg‐West Pomerania of Germany; speakers honoraria from AstraZeneca, Lilly, Novartis and travel funds from Janssen‐Cilag.
Reiner Biffar: Research grants by Federal Ministry of Education and Research Germany, Ivoclar, Sirona, Dentsply, Kavo, Wieland Ceramics, Dentaurum, Merz‐Dental, the Krupp‐Foundation, German Society of Dentistry (DGZMK), German Society of Prosthetic Dentistry and Dental Materials (DGZPW).
Thomas Kocher: Research grants by Federal Ministry of Education and Research Germany, GABA, Sirona, the Krupp‐Foundation, German Society of Periodontology.
This work is part of the
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PublicationDate July 2009
PublicationDateYYYYMMDD 2009-07-01
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  year: 2009
  text: July 2009
PublicationDecade 2000
PublicationPlace Oxford, UK
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PublicationTitle Journal of clinical periodontology
PublicationTitleAlternate J Clin Periodontol
PublicationYear 2009
Publisher Blackwell Publishing Ltd
Blackwell
Publisher_xml – name: Blackwell Publishing Ltd
– name: Blackwell
References Kamer, A. R., Craig, R. G., Dasanayake, A. P., Brys, M., Glodzik-Sobanska, L. & De Leon, M. J. (2008) Inflammation and Alzheimer's disease: possible role of periodontal diseases. Alzheimers and Dementia 4, 242-250.
Stein, P. S., Desrosiers, M., Donegan, S. J., Yepes, J. F. & Kryscio, R. J. (2007) Tooth loss, dementia and neuropathology in the Nun study. Journal of American Dental Association 138, 1314-1322.
Grau, A. J., Becher, H., Ziegler, C. M., Lichy, C., Buggle, F., Kaiser, C., Lutz, R., Bultmann, S., Preusch, M. & Dorfer, C. E. (2004) Periodontal disease as a risk factor for ischemic stroke. Stroke 35, 496-501.
John, U., Greiner, B., Hensel, E., Ludemann, J., Piek, M., Sauer, S., Adam, C., Born, G., Alte, D., Greiser, E., Haertel, U., Hense, H. W., Haerting, J., Willich, S. & Kessler, C. (2001) Study of Health In Pomerania (SHIP): a health examination survey in an east German region: objectives and design. Sozial-und Praventivmedizin 46, 186-194.
Comas-Herrera, A., Wittenberg, R., Pickard, L. & Knapp, M. (2007) Cognitive impairment in older people: future demand for long-term care services and the associated costs. International Journal of Geriatrics Psychiatry 22, 1037-1045.
Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189-198.
Ghezzi, E. M. & Ship, J. A. (2000) Dementia and oral health. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 89, 2-5.
Micheelis, W. & Schiffner, U (2006) [Fourth German Study on Oral Health 2005] 4. Deutsche Mundgesundheitsstudie 2005 (DMS-IV). Cologne: Deutscher Zahnärzte Verlag.
Schatzle, M., Loe, H., Lang, N. P., Heitz-Mayfield, L. J., Burgin, W., Anerud, A. & Boysen, H. (2003) Clinical course of chronic periodontitis. III. Patterns, variations and risks of attachment loss. Journal of Clinical Periodontology 30, 909-918.
Schmand, B., Smit, J., Lindeboom, J., Smits, C., Hooijer, C., Jonker, C. & Deelman, B. (1997) Low education is a genuine risk factor for accelerated memory decline and dementia. Journal of Clinical Epidemiology 50, 1025-1033.
Yaffe, K., Lindquist, K., Penninx, B. W., Simonsick, E. M., Pahor, M., Kritchevsky, S., Launer, L., Kuller, L., Rubin, S. & Harris, T. (2003) Inflammatory markers and cognition in well-functioning African-American and white elders. Neurology 61, 76-80.
Grabe, H. J., Lange, M., Wolff, B., Volzke, H., Lucht, M., Freyberger, H. J., John, U. & Cascorbi, I. (2005) Mental and physical distress is modulated by a polymorphism in the 5-HT transporter gene interacting with social stressors and chronic disease burden. Molecular Psychiatry 10, 220-224.
Loos, B. G., Craandijk, J., Hoek, F. J., Wertheim-van Dillen, P. M. & Van Der Velden, U. (2000) Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. Journal of Periodontology 71, 1528-1534.
Dik, M. G., Jonker, C., Hack, C. E., Smit, J. H., Comijs, H. C. & Eikelenboom, P. (2005) Serum inflammatory proteins and cognitive decline in older persons. Neurology 64, 1371-1377.
Gilbert, G. H., Duncan, R. P. & Shelton, B. J. (2003) Social determinants of tooth loss. Health Services Research 38, 1843-1862.
Phipps, K. R. & Stevens, V. J. (1995) Relative contribution of caries and periodontal disease in adult tooth loss for an HMO dental population. Journal of Public Health Dentistry 55, 250-252.
Geerts, S. O., Nys, M., De, M. P., Charpentier, J., Albert, A., Legrand, V. & Rompen, E. H. (2002) Systemic release of endotoxins induced by gentle mastication: association with periodontitis severity. Journal of Periodontology 73, 73-78.
Hensel, E., Gesch, D., Biffar, R., Bernhardt, O., Kocher, T., Splieth, C., Born, G. & John, U. (2003) Study of Health in Pomerania (SHIP): a health survey in an East German region. Objectives and design of the oral health section. Quintessence International 34, 370-378.
Schafer, J. L. (1997) Analysis of Incomplete Multivariate Data. New York: Chapman & Hall.
Thomson, W. M., Poulton, R., Milne, B. J., Caspi, A., Broughton, J. R. & Ayers, K. M. (2004) Socioeconomic inequalities in oral health in childhood and adulthood in a birth cohort. Community Dental and Oral Epidemiology 32, 345-353.
Riviere, G. R., Riviere, K. H. & Smith, K. S. (2002) Molecular and immunological evidence of oral Treponema in the human brain and their association with Alzheimer's disease. Oral Microbiology and Immunology 17, 113-118.
Chalmers, J. M., Carter, K. D. & Spencer, A. J. (2003) Oral diseases and conditions in community-living older adults with and without dementia. Special Care Dentistry 23, 7-17.
Kawachi, I. & Kennedy, B. P. (1997) The relationship of income inequality to mortality: does the choice of indicator matter? Social Science and Medicine 45, 1121-1127.
Forner, L., Larsen, T., Kilian, M. & Holmstrup, P. (2006) Incidence of bacteremia after chewing, tooth brushing and scaling in individuals with periodontal inflammation. Journal of Clinical Periodontology 33, 401-407.
Schmidt, R., Schmidt, H., Curb, J. D., Masaki, K., White, L. R. & Launer, L. J. (2002) Early inflammation and dementia: a 25-year follow-up of the Honolulu-Asia Aging Study. Annals of Neurology 52, 168-174.
Wu, B., Plassman, B. L., Crout, R. J. & Liang, J. (2008) Cognitive function and oral health among community-dwelling older adults. Journal of Gerontology A Biological Science and Medical Science 63, 595-500.
Haraszthy, V. I., Zambon, J. J., Trevisan, M., Zeid, M. & Genco, R. J. (2000) Identification of periodontal pathogens in atheromatous plaques. Journal of Periodontology 71, 1554-1560.
Abnet, C. C., Qiao, Y. L., Dawsey, S. M., Dong, Z. W., Taylor, P. R. & Mark, S. D. (2005) Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. International Journal of Epidemiology 34, 467-474.
Desvarieux, M., Schwahn, C., Volzke, H., Demmer, R. T., Ludemann, J., Kessler, C., Jacobs, D. R. Jr., John, U. & Kocher, T. (2004) Gender differences in the relationship between periodontal disease, tooth loss, and atherosclerosis. Stroke 35, 2029-2035.
Lee, S., Kawachi, I., Berkman, L. F. & Grodstein, F. (2003) Education, other socioeconomic indicators, and cognitive function. American Journal of Epidemiology 157, 712-720.
Schwahn, C., Volzke, H., Robinson, D. M., Luedemann, J., Bernhardt, O., Gesch, D., John, U. & Kocher, T. (2004) Periodontal disease, but not edentulism, is independently associated with increased plasma fibrinogen levels. Results from a population-based study. Thrombosis and Haemostasis 92, 244-252.
Henriksen, B. M., Engedal, K. & Axell, T. (2005) Cognitive impairment is associated with poor oral health in individuals in long-term care. Oral Health and Preventive Dentistry 3, 203-207.
Schafer, J. L. & Graham, J. W. (2002) Missing data: our view of the state of the art. Psychological Methods 7, 147-177.
Christensen, K., Gaist, D., Jeune, B. & Vaupel, J. W. (1998) A tooth per child?. Lancet 352, 204.
Whitmer, R. A., Gunderson, E. P., Quesenberry, C. P. Jr., Zhou, J. & Yaffe, K. (2007) Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Current Alzheimer Research 4, 103-109.
Berkman, L. F. & Syme, S. L. (1979) Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology 109, 186-204.
Splieth, C., Giesenberg, J., Fanghanel, J., Bernhardt, O. & Kocher, T. (2002) Periodontal attachment level of extractions presumably performed for periodontal reasons. Journal of Clinical Periodontology 29, 514-518.
D'Aiuto, F., Nibali, L., Parkar, M., Suvan, J. & Tonetti, M. S. (2005) Short-term effects of intensive periodontal therapy on serum inflammatory markers and cholesterol. Journal of Dental Research 84, 269-273.
Michaud, D. S., Liu, Y., Meyer, M., Giovannucci, E. & Joshipura, K. (2008) Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study. Lancet Oncology 9, 550-558.
Slade, G. D., Ghezzi, E. M., Heiss, G., Beck, J. D., Riche, E. & Offenbacher, S. (2003) Relationship between periodontal disease and C-reactive protein among adults in the Atherosclerosis Risk in Communities study. Archives of Internal Medicine 163, 1172-1179.
Sherbourne, C. D. & Stewart, A. L. (1991) The MOS social support survey. Social Science and Medicine 32, 705-714.
Paraskevas, S., Huizinga, J. D. & Loos, B. G. (2008) A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. Journal of Clinical Periodontology 35, 277-290.
Finch, C. E. & Morgan, T. E. (2007) Systemic inflammation, infection, ApoE alleles, and Alzheimer disease: a position paper. Current Alzheimer Research 4, 185-189.
Desvarieux, M., Demmer, R. T., Rundek, T., Boden-Albala, B., Jacobs, D. R. Jr., Papapanou, P. N. & Sacco, R. L. (2003) Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke 34, 2120-2125.
Musacchio, E., Perissinotto, E., Binotto, P., Sartori, L., Silva-Netto, F., Zambon, S., Manzato, E., Corti, M. C., Baggio, G. & Crepaldi, G. (2007) Tooth loss in the elderly and its association with nutritional status, socio-economic and lifestyle factors. Acta Odontologica Scandinavica 65, 78-86.
Reich, E. & Hiller, K. A. (1993) Reasons for tooth extraction in the western states of Germany. Community Dental and Oral Epidemiology 21, 379-383.
Dietrich, T., Jimenez, M., Krall Kaye, E. A., Vokonas, P. S. & Garcia, R. I. (2008) Age-dependent associations between chronic periodontitis/edentulism and risk of coronary heart disease. Circulation 117, 1668-1674.
Tan, Z. S., Beiser, A. S., Vasan, R. S., Roubenoff, R., Dinarello, C. A., Harris, T. B., Benjamin, E. J., Au, R., Kiel, D. P., Wolf, P. A. & Seshadri, S. (2007) Inflammatory mark
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References_xml – reference: Schafer, J. L. & Graham, J. W. (2002) Missing data: our view of the state of the art. Psychological Methods 7, 147-177.
– reference: Loos, B. G., Craandijk, J., Hoek, F. J., Wertheim-van Dillen, P. M. & Van Der Velden, U. (2000) Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. Journal of Periodontology 71, 1528-1534.
– reference: Kamer, A. R., Craig, R. G., Dasanayake, A. P., Brys, M., Glodzik-Sobanska, L. & De Leon, M. J. (2008) Inflammation and Alzheimer's disease: possible role of periodontal diseases. Alzheimers and Dementia 4, 242-250.
– reference: Reich, E. & Hiller, K. A. (1993) Reasons for tooth extraction in the western states of Germany. Community Dental and Oral Epidemiology 21, 379-383.
– reference: Schmidt, R., Schmidt, H., Curb, J. D., Masaki, K., White, L. R. & Launer, L. J. (2002) Early inflammation and dementia: a 25-year follow-up of the Honolulu-Asia Aging Study. Annals of Neurology 52, 168-174.
– reference: Kawachi, I. & Kennedy, B. P. (1997) The relationship of income inequality to mortality: does the choice of indicator matter? Social Science and Medicine 45, 1121-1127.
– reference: Christensen, K., Gaist, D., Jeune, B. & Vaupel, J. W. (1998) A tooth per child?. Lancet 352, 204.
– reference: Gilbert, G. H., Duncan, R. P. & Shelton, B. J. (2003) Social determinants of tooth loss. Health Services Research 38, 1843-1862.
– reference: Slade, G. D., Ghezzi, E. M., Heiss, G., Beck, J. D., Riche, E. & Offenbacher, S. (2003) Relationship between periodontal disease and C-reactive protein among adults in the Atherosclerosis Risk in Communities study. Archives of Internal Medicine 163, 1172-1179.
– reference: Abnet, C. C., Qiao, Y. L., Dawsey, S. M., Dong, Z. W., Taylor, P. R. & Mark, S. D. (2005) Tooth loss is associated with increased risk of total death and death from upper gastrointestinal cancer, heart disease, and stroke in a Chinese population-based cohort. International Journal of Epidemiology 34, 467-474.
– reference: Lee, S., Kawachi, I., Berkman, L. F. & Grodstein, F. (2003) Education, other socioeconomic indicators, and cognitive function. American Journal of Epidemiology 157, 712-720.
– reference: Berkman, L. F. & Syme, S. L. (1979) Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. American Journal of Epidemiology 109, 186-204.
– reference: Finch, C. E. & Morgan, T. E. (2007) Systemic inflammation, infection, ApoE alleles, and Alzheimer disease: a position paper. Current Alzheimer Research 4, 185-189.
– reference: Tan, Z. S., Beiser, A. S., Vasan, R. S., Roubenoff, R., Dinarello, C. A., Harris, T. B., Benjamin, E. J., Au, R., Kiel, D. P., Wolf, P. A. & Seshadri, S. (2007) Inflammatory markers and the risk of Alzheimer disease: the Framingham Study. Neurology 68, 1902-1908.
– reference: Forner, L., Larsen, T., Kilian, M. & Holmstrup, P. (2006) Incidence of bacteremia after chewing, tooth brushing and scaling in individuals with periodontal inflammation. Journal of Clinical Periodontology 33, 401-407.
– reference: Henriksen, B. M., Engedal, K. & Axell, T. (2005) Cognitive impairment is associated with poor oral health in individuals in long-term care. Oral Health and Preventive Dentistry 3, 203-207.
– reference: John, U., Greiner, B., Hensel, E., Ludemann, J., Piek, M., Sauer, S., Adam, C., Born, G., Alte, D., Greiser, E., Haertel, U., Hense, H. W., Haerting, J., Willich, S. & Kessler, C. (2001) Study of Health In Pomerania (SHIP): a health examination survey in an east German region: objectives and design. Sozial-und Praventivmedizin 46, 186-194.
– reference: Haraszthy, V. I., Zambon, J. J., Trevisan, M., Zeid, M. & Genco, R. J. (2000) Identification of periodontal pathogens in atheromatous plaques. Journal of Periodontology 71, 1554-1560.
– reference: Comas-Herrera, A., Wittenberg, R., Pickard, L. & Knapp, M. (2007) Cognitive impairment in older people: future demand for long-term care services and the associated costs. International Journal of Geriatrics Psychiatry 22, 1037-1045.
– reference: Wu, B., Plassman, B. L., Crout, R. J. & Liang, J. (2008) Cognitive function and oral health among community-dwelling older adults. Journal of Gerontology A Biological Science and Medical Science 63, 595-500.
– reference: Micheelis, W. & Schiffner, U (2006) [Fourth German Study on Oral Health 2005] 4. Deutsche Mundgesundheitsstudie 2005 (DMS-IV). Cologne: Deutscher Zahnärzte Verlag.
– reference: Dik, M. G., Jonker, C., Hack, C. E., Smit, J. H., Comijs, H. C. & Eikelenboom, P. (2005) Serum inflammatory proteins and cognitive decline in older persons. Neurology 64, 1371-1377.
– reference: Thomson, W. M., Poulton, R., Milne, B. J., Caspi, A., Broughton, J. R. & Ayers, K. M. (2004) Socioeconomic inequalities in oral health in childhood and adulthood in a birth cohort. Community Dental and Oral Epidemiology 32, 345-353.
– reference: Schmand, B., Smit, J., Lindeboom, J., Smits, C., Hooijer, C., Jonker, C. & Deelman, B. (1997) Low education is a genuine risk factor for accelerated memory decline and dementia. Journal of Clinical Epidemiology 50, 1025-1033.
– reference: Schatzle, M., Loe, H., Lang, N. P., Heitz-Mayfield, L. J., Burgin, W., Anerud, A. & Boysen, H. (2003) Clinical course of chronic periodontitis. III. Patterns, variations and risks of attachment loss. Journal of Clinical Periodontology 30, 909-918.
– reference: Phipps, K. R. & Stevens, V. J. (1995) Relative contribution of caries and periodontal disease in adult tooth loss for an HMO dental population. Journal of Public Health Dentistry 55, 250-252.
– reference: Schafer, J. L. (1997) Analysis of Incomplete Multivariate Data. New York: Chapman & Hall.
– reference: Geerts, S. O., Nys, M., De, M. P., Charpentier, J., Albert, A., Legrand, V. & Rompen, E. H. (2002) Systemic release of endotoxins induced by gentle mastication: association with periodontitis severity. Journal of Periodontology 73, 73-78.
– reference: Folstein, M. F., Folstein, S. E. & McHugh, P. R. (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189-198.
– reference: Splieth, C., Giesenberg, J., Fanghanel, J., Bernhardt, O. & Kocher, T. (2002) Periodontal attachment level of extractions presumably performed for periodontal reasons. Journal of Clinical Periodontology 29, 514-518.
– reference: Ghezzi, E. M. & Ship, J. A. (2000) Dementia and oral health. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics 89, 2-5.
– reference: Grau, A. J., Becher, H., Ziegler, C. M., Lichy, C., Buggle, F., Kaiser, C., Lutz, R., Bultmann, S., Preusch, M. & Dorfer, C. E. (2004) Periodontal disease as a risk factor for ischemic stroke. Stroke 35, 496-501.
– reference: Desvarieux, M., Schwahn, C., Volzke, H., Demmer, R. T., Ludemann, J., Kessler, C., Jacobs, D. R. Jr., John, U. & Kocher, T. (2004) Gender differences in the relationship between periodontal disease, tooth loss, and atherosclerosis. Stroke 35, 2029-2035.
– reference: Michaud, D. S., Liu, Y., Meyer, M., Giovannucci, E. & Joshipura, K. (2008) Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study. Lancet Oncology 9, 550-558.
– reference: Riviere, G. R., Riviere, K. H. & Smith, K. S. (2002) Molecular and immunological evidence of oral Treponema in the human brain and their association with Alzheimer's disease. Oral Microbiology and Immunology 17, 113-118.
– reference: Chalmers, J. M., Carter, K. D. & Spencer, A. J. (2003) Oral diseases and conditions in community-living older adults with and without dementia. Special Care Dentistry 23, 7-17.
– reference: Desvarieux, M., Demmer, R. T., Rundek, T., Boden-Albala, B., Jacobs, D. R. Jr., Papapanou, P. N. & Sacco, R. L. (2003) Relationship between periodontal disease, tooth loss, and carotid artery plaque: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Stroke 34, 2120-2125.
– reference: Dietrich, T., Jimenez, M., Krall Kaye, E. A., Vokonas, P. S. & Garcia, R. I. (2008) Age-dependent associations between chronic periodontitis/edentulism and risk of coronary heart disease. Circulation 117, 1668-1674.
– reference: Whitmer, R. A., Gunderson, E. P., Quesenberry, C. P. Jr., Zhou, J. & Yaffe, K. (2007) Body mass index in midlife and risk of Alzheimer disease and vascular dementia. Current Alzheimer Research 4, 103-109.
– reference: Grabe, H. J., Lange, M., Wolff, B., Volzke, H., Lucht, M., Freyberger, H. J., John, U. & Cascorbi, I. (2005) Mental and physical distress is modulated by a polymorphism in the 5-HT transporter gene interacting with social stressors and chronic disease burden. Molecular Psychiatry 10, 220-224.
– reference: Hensel, E., Gesch, D., Biffar, R., Bernhardt, O., Kocher, T., Splieth, C., Born, G. & John, U. (2003) Study of Health in Pomerania (SHIP): a health survey in an East German region. Objectives and design of the oral health section. Quintessence International 34, 370-378.
– reference: D'Aiuto, F., Nibali, L., Parkar, M., Suvan, J. & Tonetti, M. S. (2005) Short-term effects of intensive periodontal therapy on serum inflammatory markers and cholesterol. Journal of Dental Research 84, 269-273.
– reference: Schwahn, C., Volzke, H., Robinson, D. M., Luedemann, J., Bernhardt, O., Gesch, D., John, U. & Kocher, T. (2004) Periodontal disease, but not edentulism, is independently associated with increased plasma fibrinogen levels. Results from a population-based study. Thrombosis and Haemostasis 92, 244-252.
– reference: Stein, P. S., Desrosiers, M., Donegan, S. J., Yepes, J. F. & Kryscio, R. J. (2007) Tooth loss, dementia and neuropathology in the Nun study. Journal of American Dental Association 138, 1314-1322.
– reference: Sherbourne, C. D. & Stewart, A. L. (1991) The MOS social support survey. Social Science and Medicine 32, 705-714.
– reference: Yaffe, K., Lindquist, K., Penninx, B. W., Simonsick, E. M., Pahor, M., Kritchevsky, S., Launer, L., Kuller, L., Rubin, S. & Harris, T. (2003) Inflammatory markers and cognition in well-functioning African-American and white elders. Neurology 61, 76-80.
– reference: Paraskevas, S., Huizinga, J. D. & Loos, B. G. (2008) A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. Journal of Clinical Periodontology 35, 277-290.
– reference: Musacchio, E., Perissinotto, E., Binotto, P., Sartori, L., Silva-Netto, F., Zambon, S., Manzato, E., Corti, M. C., Baggio, G. & Crepaldi, G. (2007) Tooth loss in the elderly and its association with nutritional status, socio-economic and lifestyle factors. Acta Odontologica Scandinavica 65, 78-86.
– reference: Hyman, J. (2006) The importance of assessing confounding and effect modification in research involving periodontal disease and systemic diseases. Journal of Clinical Periodontology 33, 102-103.
– volume: 89
  start-page: 2
  year: 2000
  end-page: 5
  article-title: Dementia and oral health
  publication-title: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontics
– volume: 65
  start-page: 78
  year: 2007
  end-page: 86
  article-title: Tooth loss in the elderly and its association with nutritional status, socio‐economic and lifestyle factors
  publication-title: Acta Odontologica Scandinavica
– volume: 21
  start-page: 379
  year: 1993
  end-page: 383
  article-title: Reasons for tooth extraction in the western states of Germany
  publication-title: Community Dental and Oral Epidemiology
– volume: 50
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Snippet Objectives: Chronic subclinical inflammation may elevate the risk of cognitive impairment. Periodontitis is associated with subclinical inflammation and...
Objectives: Chronic subclinical inflammation may elevate the risk of cognitive impairment. Periodontitis is associated with subclinical inflammation and...
Chronic subclinical inflammation may elevate the risk of cognitive impairment. Periodontitis is associated with subclinical inflammation and accounts in part...
Grabe HJ, Schwahn C, Voelzke H, Spitzer C, Freyberger HJ, John U, Mundt T, Biffar R, Kocher T. Tooth loss and cognitive impairment. J Clin Periodontol 2009....
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SubjectTerms Aged
Biological and medical sciences
Causality
Chi-Square Distribution
Cognition Disorders - diagnosis
Cognition Disorders - epidemiology
cognitive impairment
Comorbidity
Cross-Sectional Studies
Facial bones, jaws, teeth, parodontium: diseases, semeiology
Female
general population
Geriatric Assessment
Germany - epidemiology
Humans
Male
Medical sciences
Mental Status Schedule
Non tumoral diseases
Otorhinolaryngology. Stomatology
periodontitis
Periodontitis - epidemiology
Regression Analysis
Sex Factors
Socioeconomic Factors
Statistics, Nonparametric
tooth loss
Tooth Loss - epidemiology
Title Tooth loss and cognitive impairment
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https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1600-051X.2009.01426.x
https://www.ncbi.nlm.nih.gov/pubmed/19538327
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https://www.proquest.com/docview/67403344
Volume 36
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