Association between periodontitis and cognitive impairment in older adults: A cross-sectional study of the National Health and Nutrition Examination Survey

<h2>Abstract</h2><h3>Objectives</h3> Periodontitis has been hypothesized as a modifiable risk factor for cognitive decline, yet population-based evidence remains limited. This study examined the relationship between periodontitis and cognitive impairment among the US seniors over 60. <h3>Methods</h3> This is a cross-sectional study based on the National Health and Nutrition Examination Survey (NHANES) 2011–2014. Periodontitis cases were identified and categorized as either none/mild or moderate/severe. Cognitive function was assessed using three questionnaire survey: the Consortium to Establish a Registry for Alzheimer's Disease Word Learning subtest (CERAD-WL), the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). Scores below the lowest quartile indicated cognitive impairment. A binary logistic regression was conducted to explore the relationship between periodontitis status and cognitive impairment in individuals over 60 years old. <h3>Results</h3> The findings indicated that 52.6 % of the sample (n = 2514) had moderate/severe periodontitis. In both CERAD-WL and DSST, the median score in the moderate/severe periodontitis cohort was high than that in the no/mild periodontitis cohort (<i>P</i> = .046,<i>P</i> = .010,respectively). Logistic regression model revealed an odds ratio of 1.605 (95 %CI: 1.407–1.898, <i>P</i> = .013) in DSST for the moderate/severe periodontitis group in unadjusted model, 1.288 (95 % CI:1.022–1.624, <i>P</i> = .032) in model 2 confounding demographic variables, and 1.290 (95 %CI: 1.021–1.630, <i>P</i> = .033) in model 3 confounding all covariants. Furthermore, the moderate/severe periodontitis is significantly associated with several factors: gender, the poverty income ratio(PIR) and dental visit frequency. <h3>Conclusion</h3> This study reveals a significant association between periodontitis and cognitive impairment among US seniors aged 60 and above in a nationally representative sample.