Poor periodontal health is linked to impaired cognitive performance in older people: A cross-sectional study

Abstract Background At present, there is no cure for dementia, and most available treatments have shown marginal or no effect. This fact makes it crucial to identify factors that increase the risk of cognitive decline in the population. Evidence suggests that poor periodontal health may be one of those factors; nonetheless, to ascertain this possibility, it is necessary to account for the influence of education, as it is frequently the determining factor that explains the association between a risk factor and cognitive impairment. Therefore, this study aimed to determine whether poor periodontal health is associated with impaired cognitive performance in older people from an agricultural community in Chile, independent of education. Methods A cross-sectional study was conducted with the entire universe of participants older than 60 years from the MAUCO cohort in 2015. The exposure of interest was periodontal health status assessed through a proxy measure based on gum appearance (color) and bleeding, and individuals were categorized into three groups: healthy periodontium, signs of possible disease, and unhealthy periodontium. The dependent variable was cognitive performance evaluated using the ACE-R test. The confounding effect generated by sociodemographic factors was controlled through regression models: linear regression with the score obtained in the ACE-R test and multinomial regression for normal cognition, cognitive impairment, and dementia as outcomes. Results The study included 2,716 participants with a mean age of 65.7 ± 4 years, of whom 52% were women and 63% had a low educational level. Unhealthy periodontium was observed in 10.8% of the individuals, while 17.6% had cognitive impairment or dementia. People with an unhealthy periodontium scored two points lower on the ACE-R test and were almost twice as likely to have dementia (OR 1.86 95% CI 1.07–3.25) than those with periodontal health, regardless of age, sex, and educational level. Conclusion Older people with unhealthy periodontium seem to have worse cognitive performance and a higher possibility of suffering from dementia than those with healthy periodontium, regardless of sociodemographic factors. Education does not explain this outcome.