Evidence map›Paper›PMID 36073186›Full record

SynthesisJournal of the American Geriatrics Society2022

Periodontal health, cognitive decline, and dementia: A systematic review and meta-analysis of longitudinal studies.

Sam Asher, Ruth Stephen, Päivi Mäntylä, Anna Liisa Suominen, Alina Solomon

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of the American Geriatrics Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 92 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
92citing papers in PubMed, 8 pooled it
17.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

92 citing papers in PubMed, 8 syntheses or guidelines pooled it, 127 citations in OpenAlex.

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  8. Association Between Periodontitis and Mild Cognitive Impairment, Alzheimer's Disease, and Dementia: An Umbrella Review With Evidence Stratification.Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry
    Pooled it
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32 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 1 institution in 3 countries.

Sam AsherInstitute of Dentistry, University of Eastern Finland, Kuopio, Finland.ORCID 0000-0003-3093-4720
Ruth StephenNeurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
Päivi MäntyläInstitute of Dentistry, University of Eastern Finland, Kuopio, Finland.
Anna Liisa SuominenInstitute of Dentistry, University of Eastern Finland, Kuopio, Finland.
Alina SolomonNeurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
University of Eastern Finland · FI

Funding

Ella ja Georg Ehrnroothin SäätiöEuropean Research Council 804371Juho Vainion SäätiöMinerva FoundationPäivikki ja Sakari Sohlbergin SäätiöSuomen AivosäätiöSuomen Kulttuurirahasto
6 · The paper itself

Abstract

backgroundEmerging evidence indicates that poor periodontal health adversely impacts cognition. This review examined the available longitudinal evidence concerning the effect of poor periodontal health on cognitive decline and dementia.

methodsComprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. Longitudinal studies having periodontal health as exposure and cognitive decline and/or dementia as outcomes were considered. Random effects pooled estimates and 95% confidence intervals were generated (pooled odds ratio for cognitive decline and hazards ratio for dementia) to assess whether poor periodontal health increases the risk of cognitive decline and dementia. Heterogeneity between studies was estimated by I

resultsAdopted search strategy produced 2132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in this review. Poor periodontal health (reflected by having periodontitis, tooth loss, deep periodontal pockets, or alveolar bone loss) was associated with both cognitive decline (OR = 1.23; 1.05-1.44) and dementia (HR = 1.21; 1.07-1.38). Further analysis, based on measures of periodontal assessment, found tooth loss to independently increase the risk of both cognitive decline (OR = 1.23; 1.09-1.39) and dementia (HR = 1.13; 1.04-1.23). Stratified analysis based on the extent of tooth loss indicated partial tooth loss to be important for cognitive decline (OR = 1.50; 1.02-2.23) and complete tooth loss for dementia (HR = 1.23; 1.05-1.45). However, the overall quality of evidence was low, and associations were at least partly due to reverse causality.

conclusionsPoor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well-designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted.

Indexed as

Cognitive DysfunctionDementiaPeriodontitisTooth LossHumansLongitudinal Studiescognitive declinedementiaperiodontitistooth loss

Identifiers

PMID36073186
PMCPMC9826143
OpenAlexW4294991989

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.