Skip to content
2000
image of Predictive Value of Complete Blood Count Parameters for Alzheimer's Disease in Relation to Periodontal Status

Abstract

Introduction/Objective

Given the role of inflammation in the development of both Alzheimer's disease (AD) and periodontal disease, it is plausible that periodontal disease may influence the progression of AD. Complete blood count (CBC) parameters may also serve as predictive indicators for this condition. This study investigated the predictive value of CBC parameters on the progression of AD in patients with periodontal disease.

Methods

Data from a prospective cohort study (n=90) with 6-month follow-up was analyzed. AD was assessed based on the Clinical Dementia Rating Scale. Records of C-reactive Protein (CRP) levels and CBC parameters measured within the 6 months preceding the participation date were evaluated. Cognitive assessments at the initial and 6th-month follow-up were performed using the Standardized Mini-Mental Test (SMMT). All patients underwent clinical periodontal examination.

Results and Discussion

The difference in SMMT score change (∆SMMT) and platelet distribution width (PDW) value between groups with and without periodontitis was statistically notable (0.05). The presence of periodontitis was found to be significantly associated with age, ∆SMMT, and PDW values using the multivariate logistic regression model (0.05). Furthermore, having Stage II and Stage III AD, periodontitis, age factor, and mean platelet volume (MPV) value had a notable impact on ∆SMMT (0.05). These findings may indicate that systemic inflammation as reflected by complete blood count parameters (such as PDW and MPV) may play a predictive role in cognitive decline in Alzheimer's disease patients with periodontitis.

Conclusion

PDW and MPV levels may have a predictive significance in clarifying the association between periodontitis and AD progression.

Loading

Article metrics loading...

/content/journals/car/10.2174/0115672050388220250511174043
2025-05-19
2025-09-05
Loading full text...

Full text loading...

References

  1. McKhann G.M. Knopman D.S. Chertkow H. Hyman B.T. Jack C.R. Jr Kawas C.H. Klunk W.E. Koroshetz W.J. Manly J.J. Mayeux R. Mohs R.C. Morris J.C. Rossor M.N. Scheltens P. Carrillo M.C. Thies B. Weintraub S. Phelps C.H. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011 7 3 263 269 10.1016/j.jalz.2011.03.005 21514250
    [Google Scholar]
  2. 2024 Alzheimer’s disease facts and figures. Alzheimers Dement. 2024 20 5 3708 3821 10.1002/alz.13809 38689398
    [Google Scholar]
  3. Zvěřová M. Clinical aspects of Alzheimer’s disease. Clin. Biochem. 2019 72 3 6 10.1016/j.clinbiochem.2019.04.015 31034802
    [Google Scholar]
  4. Hardy J. Allsop D. Amyloid deposition as the central event in the aetiology of Alzheimer’s disease. Trends Pharmacol. Sci. 1991 12 10 383 388 10.1016/0165‑6147(91)90609‑V 1763432
    [Google Scholar]
  5. Selkoe D.J. The molecular pathology of Alzheimer’s disease. Neuron 1991 6 4 487 498 10.1016/0896‑6273(91)90052‑2 1673054
    [Google Scholar]
  6. Winblad B. Amouyel P. Andrieu S. Ballard C. Brayne C. Brodaty H. Cedazo-Minguez A. Dubois B. Edvardsson D. Feldman H. Fratiglioni L. Frisoni G.B. Gauthier S. Georges J. Graff C. Iqbal K. Jessen F. Johansson G. Jönsson L. Kivipelto M. Knapp M. Mangialasche F. Melis R. Nordberg A. Rikkert M.O. Qiu C. Sakmar T.P. Scheltens P. Schneider L.S. Sperling R. Tjernberg L.O. Waldemar G. Wimo A. Zetterberg H. Defeating Alzheimer’s disease and other dementias: A priority for European science and society. Lancet Neurol. 2016 15 5 455 532 10.1016/S1474‑4422(16)00062‑4 26987701
    [Google Scholar]
  7. DeTure M.A. Dickson D.W. The neuropathological diagnosis of Alzheimer’s disease. Mol. Neurodegener. 2019 14 1 32 10.1186/s13024‑019‑0333‑5 31375134
    [Google Scholar]
  8. Liu P.P. Xie Y. Meng X-Y. Kang J-S. History and progress of hypotheses and clinical trials for Alzheimer’s disease. Signal Transduct. Target. Ther. 2019 4 1 29 10.1038/s41392‑019‑0063‑8
    [Google Scholar]
  9. Silva M.V.F. Loures C.M.G. Alves L.C.V. de Souza L.C. Borges K.B.G. Carvalho M.G. Alzheimer’s disease: Risk factors and potentially protective measures. J. Biomed. Sci. 2019 26 1 33 10.1186/s12929‑019‑0524‑y 31072403
    [Google Scholar]
  10. Guo Y. Wang Q. Chen S. Xu C. Functions of amyloid precursor protein in metabolic diseases. Metabolism 2021 115 154454 10.1016/j.metabol.2020.154454 33248065
    [Google Scholar]
  11. Leng F. Edison P. Neuroinflammation and microglial activation in Alzheimer disease: Where do we go from here? Nat. Rev. Neurol. 2021 17 3 157 172 10.1038/s41582‑020‑00435‑y 33318676
    [Google Scholar]
  12. McKhann G. Drachman D. Folstein M. Katzman R. Price D. Stadlan E.M. Clinical diagnosis of Alzheimer’s disease. Neurology 1984 34 7 939 944 10.1212/WNL.34.7.939 6610841
    [Google Scholar]
  13. Langa K.M. Levine D.A. The diagnosis and management of mild cognitive impairment: A clinical review. JAMA 2014 312 23 2551 2561 10.1001/jama.2014.13806 25514304
    [Google Scholar]
  14. Song F. Poljak A. Valenzuela M. Mayeux R. Smythe G.A. Sachdev P.S. Meta-analysis of plasma amyloid-β levels in Alzheimer’s disease. J. Alzheimers Dis. 2011 26 2 365 375 10.3233/JAD‑2011‑101977 21709378
    [Google Scholar]
  15. Chen L. Niu X. Wang Y. Lv S. Zhou X. Yang Z. Peng D. Plasma tau proteins for the diagnosis of mild cognitive impairment and Alzheimer’s disease: A systematic review and meta-analysis. Front. Aging Neurosci. 2022 14 942629 10.3389/fnagi.2022.942629 35959295
    [Google Scholar]
  16. Gemmell E. Marshall R. Seymour G.J. Cytokines and prostaglandins in immune homeostasis and tissue destruction in periodontal disease. Periodontol. 2000 1997 14 1 112 143 10.1111/j.1600‑0757.1997.tb00194.x 9567968
    [Google Scholar]
  17. Loos B.G. Craandijk J. Hoek F.J. Dillen P.M.E.W. Van Der Velden U. Elevation of systemic markers related to cardiovascular diseases in the peripheral blood of periodontitis patients. J. Periodontol. 2000 71 10 1528 1534 10.1902/jop.2000.71.10.1528 11063384
    [Google Scholar]
  18. Papapanou P.N. Sanz M. Buduneli N. Dietrich T. Feres M. Fine D.H. Flemmig T.F. Garcia R. Giannobile W.V. Graziani F. Greenwell H. Herrera D. Kao R.T. Kebschull M. Kinane D.F. Kirkwood K.L. Kocher T. Kornman K.S. Kumar P.S. Loos B.G. Machtei E. Meng H. Mombelli A. Needleman I. Offenbacher S. Seymour G.J. Teles R. Tonetti M.S. Periodontitis: Consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J. Periodontol. 2018 89 S1 S173 S182 10.1002/JPER.17‑0721 29926951
    [Google Scholar]
  19. Hajishengallis G. Chavakis T. Lambris J.D. Current understanding of periodontal disease pathogenesis and targets for host-modulation therapy. Periodontol. 2000 2020 84 1 14 34 10.1111/prd.12331 32844416
    [Google Scholar]
  20. Kinane D.F. Stathopoulou P.G. Papapanou P.N. Periodontal diseases. Nat. Rev. Dis. Primers 2017 3 1 17038 10.1038/nrdp.2017.38
    [Google Scholar]
  21. Ide M. Harris M. Stevens A. Sussams R. Hopkins V. Culliford D. Fuller J. Ibbett P. Raybould R. Thomas R. Puenter U. Teeling J. Perry V.H. Holmes C. Periodontitis and cognitive decline in Alzheimer’s disease. PLoS One 2016 11 3 0151081 10.1371/journal.pone.0151081 26963387
    [Google Scholar]
  22. Iwasaki M. Yoshihara A. Kimura Y. Sato M. Wada T. Sakamoto R. Ishimoto Y. Fukutomi E. Chen W. Imai H. Fujisawa M. Okumiya K. Taylor G.W. Ansai T. Miyazaki H. Matsubayashi K. Longitudinal relationship of severe periodontitis with cognitive decline in older Japanese. J. Periodontal Res. 2016 51 5 681 688 10.1111/jre.12348 26740384
    [Google Scholar]
  23. Page R.C. The pathobiology of periodontal diseases may affect systemic diseases: Inversion of a paradigm. Ann. Periodontol. 1998 3 1 108 120 10.1902/annals.1998.3.1.108 9722695
    [Google Scholar]
  24. Geerts S.O. Nys M. De Mol P. Charpentier J. Albert A. Legrand V. Rompen E.H. Systemic release of endotoxins induced by gentle mastication: Association with periodontitis severity. J. Periodontol. 2002 73 1 73 78 10.1902/jop.2002.73.1.73 11846202
    [Google Scholar]
  25. Kamer A.R. Craig R.G. Dasanayake A.P. Brys M. Glodzik-Sobanska L. de Leon M.J. Inflammation and Alzheimer’s disease: Possible role of periodontal diseases. Alzheimers Dement. 2008 4 4 242 250 10.1016/j.jalz.2007.08.004 18631974
    [Google Scholar]
  26. Loos B.G. Systemic markers of inflammation in periodontitis. J. Periodontol. 2005 76 11S 2106 2115 10.1902/jop.2005.76.11‑S.2106
    [Google Scholar]
  27. Singh A. Narang D. Kaur R. Estimation of MCV, PLC, neutrophil lymphocyte ratio, PCT, PDW, PLV levels in periodontitis. Europ. J. Biotechnol. Biosci. 2022 10 2 51 54
    [Google Scholar]
  28. Christan C. Dietrich T. Hägewald S. Kage A. Bernimoulin J.P. White blood cell count in generalized aggressive periodontitis after non-surgical therapy. J. Clin. Periodontol. 2002 29 3 201 206 10.1034/j.1600‑051x.2002.290303.x 11940137
    [Google Scholar]
  29. Nicu E.A. Van Der Velden U. Nieuwland R. Everts V. Loos B.G. Elevated platelet and leukocyte response to oral bacteria in periodontitis. J. Thromb. Haemost. 2009 7 1 162 170 10.1111/j.1538‑7836.2008.03219.x 18983491
    [Google Scholar]
  30. Papapanagiotou D. Nicu E.A. Bizzarro S. Gerdes V.E.A. Meijers J.C. Nieuwland R. van der Velden U. Loos B.G. Periodontitis is associated with platelet activation. Atherosclerosis 2009 202 2 605 611 10.1016/j.atherosclerosis.2008.05.035 18617175
    [Google Scholar]
  31. Gokhale S.R. Sumanth S. Padhye A.M. Evaluation of blood parameters in patients with chronic periodontitis for signs of anemia. J. Periodontol. 2010 81 8 1202 1206 10.1902/jop.2010.100079 20476889
    [Google Scholar]
  32. Radafshar G. Shad B. Ariamajd E. Geranmayeh S. Effect of intensive non-surgical treatment on the level of serum inflammatory markers in advanced periodontitis. J. Dent. 2010 7 1 24 30 21998772
    [Google Scholar]
  33. Pradeep A.R. Anuj S. Raju A. Anemia of chronic disease and chronic periodontitis: Does periodontal therapy have an effect on anemic status? J. Periodontol. 2011 82 3 388 394 10.1902/jop.2010.100336 20843237
    [Google Scholar]
  34. Al-Rasheed A. Elevation of white blood cells and platelet counts in patients having chronic periodontitis. Saudi Dent. J. 2012 24 1 17 21 10.1016/j.sdentj.2011.10.006 23960523
    [Google Scholar]
  35. Bansal T. Dhruvakumar D. Pandey A. Comparative evaluation of C-reactive protein in peripheral blood of patients with healthy gingiva, gingivitis and chronic periodontitis: A clinical and particle-enhanced turbidimetric immuno-analysis. J. Indian Soc. Periodontol. 2014 18 6 739 743 10.4103/0972‑124X.147410 25624631
    [Google Scholar]
  36. Kumar B.P. Khaitan T. Ramaswamy P. Sreenivasulu P. Uday G. Velugubantla R.G. Association of chronic periodontitis with white blood cell and platelet count - A case control study. J. Clin. Exp. Dent. 2014 6 3 e214 e217 10.4317/jced.51292 25136419
    [Google Scholar]
  37. Patel M. Shakir Q. Shetty A. Interrelationship between chronic periodontitis and anemia: A 6-month follow-up study. J. Indian Soc. Periodontol. 2014 18 1 19 25 10.4103/0972‑124X.128194 24744539
    [Google Scholar]
  38. Doğan B. Fentoğlu Ö. Kırzıoğlu F.Y. Kemer E.S. Köroğlu B.K. Aksu O. Çarsancaklı S.A. Orhan H. Lipoxin A4 and neutrophil/lymphocyte ratio: A possible indicator in achieved systemic risk factors for periodontitis. Med. Sci. Monit. 2015 21 2485 2493 10.12659/MSM.895115 26298769
    [Google Scholar]
  39. Anand P.S. Total and differential leukocyte counts in the peripheral blood of patients with generalised aggressive periodontitis. Oral. Health Prev. Dent. 2016 14 5 443 450 10.3290/j.ohpd.a36470
    [Google Scholar]
  40. Azeez H. Abdulhaq A. Salih Z. Impact of non-surgical periodontal treatment on total wbc count in patients with periodontitis. Erbil Dental Journal 2018 1 2 86 92 10.15218/edj.2018.12
    [Google Scholar]
  41. Laky M. Anscheringer I. Wolschner L. Heber S. Haririan H. Schrottmaier W.C. Kral-Pointner J.B. Salzmann M. Volf I. Moritz A. Assinger A. Periodontal treatment limits platelet activation in patients with periodontitis—a controlled-randomized intervention trial. J. Clin. Periodontol. 2018 45 9 1090 1097 10.1111/jcpe.12980 29972709
    [Google Scholar]
  42. Nibali L. Darbar U. Rakmanee T. Donos N. Anemia of inflammation associated with periodontitis: Analysis of two clinical studies. J. Periodontol. 2019 90 11 1252 1259 10.1002/JPER.19‑0124 31119743
    [Google Scholar]
  43. Mutthineni R.B. Ramishetty A. Gojja P. Muralidaran G. Burle V.V.A. Platelet indices be a new biomarker for periodontal disease. Contemp. Clin. Dent. 2021 12 3 289 293 10.4103/ccd.ccd_461_20 34759687
    [Google Scholar]
  44. Bhattacharya H.S. Srivastava R. Gummaluri S.S. Agarwal M.C. Bhattacharya P. Astekar M.S. Comparison of blood parameters between periodontitis patients and healthy participants. J. Oral Maxillofac. Pathol. 2022 26 1 77 81 10.4103/jomfp.jomfp_349_21 35571313
    [Google Scholar]
  45. Karaduran K. Aydogdu A. Gelisin O. Gunpinar S. Investigating the potential clinical impact of periodontitis on the progression of Alzheimer’s disease: A prospective cohort study. Clin. Oral Investig. 2023 28 1 67 10.1007/s00784‑023‑05445‑w 38159159
    [Google Scholar]
  46. von Elm E. Altman D.G. Egger M. Pocock S.J. Gøtzsche P.C. Vandenbroucke J.P. The strengthening the reporting of observational studies in epidemiology (strobe) statement: Guidelines for reporting observational studies. Int. J. Surg. 2014 12 12 1495 1499 10.1016/j.ijsu.2014.07.013 25046131
    [Google Scholar]
  47. Edition F. Diagnostic and statistical manual of mental disorders. Am Psychiatric Assoc 2013 21 21 591 643
    [Google Scholar]
  48. Morris J.C. The Clinical Dementia Rating (CDR): Current version and scoring rules. Young 1993 43 11 2412 2414 10.1212/wnl.43.11.2412‑a
    [Google Scholar]
  49. Folstein M.F. Folstein S.E. McHugh P.R. “Mini-mental state”. J. Psychiatr. Res. 1975 12 3 189 198 10.1016/0022‑3956(75)90026‑6 1202204
    [Google Scholar]
  50. Chang C.Y. Liang H.J. Chow S.Y. Chen S.M. Liu D.Z. Hemorheological mechanisms in Alzheimer’s disease. Microcirculation 2007 14 6 627 634 10.1080/10739680701411056 17710633
    [Google Scholar]
  51. Wang R. Jin D. Li Y. Liang Q. Decreased mean platelet volume and platelet distribution width are associated with mild cognitive impairment and Alzheimer’s disease. J. Psychiatr. Res. 2013 47 5 644 649 10.1016/j.jpsychires.2013.01.014 23395109
    [Google Scholar]
  52. Koç E.R. Uzar E. Çirak Y. Parlak Demi̇r Y. İlhan A. The increase of mean platelet volume in patients with Alzheimer disease. Turk. J. Med. Sci. 2014 44 6 1060 1066 10.3906/sag‑1212‑5 25552162
    [Google Scholar]
  53. Liang Q.C. Jin D. Li Y. Wang R.T. Mean platelet volume and platelet distribution width in vascular dementia and Alzheimer’s disease. Platelets 2014 25 6 433 438 10.3109/09537104.2013.831064 24175580
    [Google Scholar]
  54. Rembach A. Watt A.D. Wilson W.J. Rainey-Smith S. Ellis K.A. Rowe C.C. Villemagne V.L. Macaulay S.L. Bush A.I. Martins R.N. Ames D. Masters C.L. Doecke J.D. An increased neutrophil–lymphocyte ratio in Alzheimer’s disease is a function of age and is weakly correlated with neocortical amyloid accumulation. J. Neuroimmunol. 2014 273 1-2 65 71 10.1016/j.jneuroim.2014.05.005 24907904
    [Google Scholar]
  55. Chen S.H. Bu X.L. Jin W.S. Shen L.L. Wang J. Zhuang Z.Q. Zhang T. Zeng F. Yao X.Q. Zhou H.D. Wang Y.J. Altered peripheral profile of blood cells in Alzheimer disease. Medicine 2017 96 21 6843 10.1097/MD.0000000000006843 28538375
    [Google Scholar]
  56. Kalelioglu T. Yuruyen M. Gultekin G. Yavuzer H. Özturk Y. Kurt M. Topcu Y. Doventas A. Emul M. Neutrophil and platelet to lymphocyte ratios in people with subjective, mild cognitive impairment and early Alzheimer’s disease. Psychogeriatrics 2017 17 6 506 508 10.1111/psyg.12260 28386987
    [Google Scholar]
  57. An P. Zhou X. Du Y. Zhao J. Song A. Liu H. Ma F. Huang G. Association of neutrophil-lymphocyte ratio with mild cognitive impairment in elderly chinese adults: A case-control study. Curr. Alzheimer Res. 2020 16 14 1309 1315 10.2174/1567205017666200103110521 31902361
    [Google Scholar]
  58. Dong X. Nao J. Shi J. Zheng D. Predictive value of routine peripheral blood biomarkers in Alzheimer’s disease. Front. Aging Neurosci. 2019 11 332 10.3389/fnagi.2019.00332 31866854
    [Google Scholar]
  59. Wu K. Association between the alterations in the blood routine check parameters and cognitive impairment in the shenzhen ageing-related disorder cohort in china. Res. Square 2021 1 8 10.21203/rs.3.rs‑796144/v1
    [Google Scholar]
  60. Kara S.P. Altunan B. Unal A. Investigation of the peripheral inflammation (neutrophil–lymphocyte ratio) in two neurodegenerative diseases of the central nervous system. Neurol. Sci. 2022 43 3 1799 1807 10.1007/s10072‑021‑05507‑5 34331157
    [Google Scholar]
  61. Algul F.E. Kaplan Y. Increased systemic immune-inflammation index as a novel indicator of alzheimer’s disease severity. J. Geriatr. Psychiatry Neurol. 2025 38 3 214 222 10.1177/08919887241280880 39271460
    [Google Scholar]
  62. Fu J. Lai X. Zhang C. Wei Q. Chen X. Shang H. Correlation analysis of peripheral platelet markers and disease phenotypes in Alzheimer’s disease. Alzheimers Dement. 2024 20 6 4366 4372 10.1002/alz.13841 38713702
    [Google Scholar]
  63. Zhou C. Liu Y. Bai J. Luo Y. Song J. Feng P. Mean platelet volume is associated with periodontitis: A cross-sectional study. BMC Oral Health 2024 24 1 461 10.1186/s12903‑024‑04223‑8 38627719
    [Google Scholar]
  64. Botelho J. Machado V. Hussain S.B. Zehra S.A. Proença L. Orlandi M. Mendes J.J. D’Aiuto F. Periodontitis and circulating blood cell profiles: A systematic review and meta-analysis. Exp. Hematol. 2021 93 1 13 10.1016/j.exphem.2020.10.001 33068648
    [Google Scholar]
  65. de Souza A.B. Okawa R.T.P. Silva C.O. Araújo M.G. Short-term changes on C-reactive protein (CRP) levels after non-surgical periodontal treatment in systemically healthy individuals. Clin. Oral Investig. 2017 21 1 477 484 10.1007/s00784‑016‑1817‑0 27068411
    [Google Scholar]
  66. Lee J.H. Mun S.J. Relationship between C-reactive protein level and periodontitis and systemic diseases. J. Periodontol. 2024 95 5 494 501 10.1002/JPER.23‑0008 37843067
    [Google Scholar]
  67. Anstey K.J. von Sanden C. Salim A. O’Kearney R. Smoking as a risk factor for dementia and cognitive decline: A meta-analysis of prospective studies. Am. J. Epidemiol. 2007 166 4 367 378 10.1093/aje/kwm116 17573335
    [Google Scholar]
  68. Gudala K. Bansal D. Schifano F. Bhansali A. Diabetes mellitus and risk of dementia: A meta-analysis of prospective observational studies. J. Diabetes Investig. 2013 4 6 640 650 10.1111/jdi.12087 24843720
    [Google Scholar]
  69. Abell J.G. Kivimäki M. Dugravot A. Tabak A.G. Fayosse A. Shipley M. Sabia S. Singh-Manoux A. Association between systolic blood pressure and dementia in the Whitehall II cohort study: Role of age, duration, and threshold used to define hypertension. Eur. Heart J. 2018 39 33 3119 3125 10.1093/eurheartj/ehy288 29901708
    [Google Scholar]
  70. Paouri E. Georgopoulos S. Systemic and CNS inflammation crosstalk: Implications for Alzheimer’s disease. Curr. Alzheimer Res. 2019 16 6 559 574 10.2174/1567205016666190321154618 30907316
    [Google Scholar]
  71. Chen C.K. Wu Y.T. Chang Y.C. Association between chronic periodontitis and the risk of Alzheimer’s disease: A retrospective, population-based, matched-cohort study. Alzheimers Res. Ther. 2017 9 1 56 10.1186/s13195‑017‑0282‑6 28784164
    [Google Scholar]
  72. Tzeng N.S. Chung C.H. Yeh C.B. Huang R.Y. Yuh D.Y. Huang S.Y. Lu R.B. Chang H.A. Kao Y.C. Chiang W.S. Chou Y.C. Chien W.C. Are chronic periodontitis and gingivitis associated with dementia? A nationwide, retrospective, matched-cohort study in Taiwan. Neuroepidemiology 2016 47 2 82 93 10.1159/000449166 27618156
    [Google Scholar]
  73. Marruganti C. Periodontitis and low cognitive performance: A population-based study. J. Clin. Periodontol. 2021 50 4 418 429 10.1111/jcpe.13779
    [Google Scholar]
  74. Stein P.S. Desrosiers M. Donegan S.J. Yepes J.F. Kryscio R.J. Tooth loss, dementia and neuropathology in the Nun Study. J. Am. Dent. Assoc. 2007 138 10 1314 1322 10.14219/jada.archive.2007.0046 17908844
    [Google Scholar]
  75. Kaye E.K. Valencia A. Baba N. Spiro A. III Dietrich T. Garcia R.I. Tooth loss and periodontal disease predict poor cognitive function in older men. J. Am. Geriatr. Soc. 2010 58 4 713 718 10.1111/j.1532‑5415.2010.02788.x 20398152
    [Google Scholar]
  76. Gil-Montoya J.A. Sanchez-Lara I. Carnero-Pardo C. Fornieles F. Montes J. Vilchez R. Burgos J.S. Gonzalez-Moles M.A. Barrios R. Bravo M. Is periodontitis a risk factor for cognitive impairment and dementia? A case-control study. J. Periodontol. 2015 86 2 244 253 10.1902/jop.2014.140340 25345338
    [Google Scholar]
  77. Shin H.S. Shin M.S. Ahn Y.B. Choi B.Y. Nam J.H. Kim H.D. Periodontitis is associated with cognitive impairment in elderly Koreans: Results from the Yangpyeong cohort study. J. Am. Geriatr. Soc. 2016 64 1 162 167 10.1111/jgs.13781 26782867
    [Google Scholar]
  78. Kim D.H. Han G.S. The relationship between periodontal disease and cognitive impairment in older adults of Korea. Spec. Care Dentist. 2022 42 2 170 176 10.1111/scd.12657 34614224
    [Google Scholar]
  79. Ma K.S. Hasturk H. Carreras I. Dedeoglu A. Veeravalli J.J. Huang J.Y. Kantarci A. Wei J.C. Dementia and the risk of periodontitis: A population-based cohort study. J. Dent. Res. 2022 101 3 270 277 10.1177/00220345211037220 34643147
    [Google Scholar]
  80. Gu W. Li J. Li F. Ho T.E. Feng X. Wang Y. Fan M. Cui M. Xu K. Chen X. Lu H. Jiang Y. Association between oral health and cognitive function among Chinese older adults: The Taizhou imaging study. BMC Oral Health 2023 23 1 640 10.1186/s12903‑023‑03353‑9 37670297
    [Google Scholar]
  81. Dziedzic A. Is periodontitis associated with age-related cognitive impairment? the systematic review, confounders assessment and meta-analysis of clinical studies. Int. J. Mol. Sci. 2022 23 23 15320 10.3390/ijms232315320 36499656
    [Google Scholar]
/content/journals/car/10.2174/0115672050388220250511174043
Loading
/content/journals/car/10.2174/0115672050388220250511174043
Loading

Data & Media loading...

Supplements

Supplementary material is available on the publisher's website along with the published article.

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test