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Cited by 359Dementia and Cognitive Impairment ResearchOral microbiology and periodontitis researchAlzheimer's disease research and treatments

Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-cohort study

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Chen, Chang-Kai, Wu, Yung-Tsan, Chang, Yu-Chao·2017·Alzheimer's Research & Therapy
DOI 10.1186/s13195-017-0282-6PMC PMC5547465
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Abstract

BACKGROUND: Although recent short-term cross-sectional studies have revealed that chronic periodontitis (CP) may be a risk factor for increased cognitive impairment in patients with Alzheimer's disease (AD), systematic reviews and long-term longitudinal studies have provided less clear evidence regarding the relationship between CP and AD. Therefore, we conducted a retrospective cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with CP are at increased risk of developing AD. METHODS: We conducted a retrospective matched-cohort study using the NHIRD of Taiwan. We identified 9291 patients newly diagnosed with CP between 1997 and 2004. A total of 18,672 patients without CP were matched to the patient cohort according to sex, age, index year, co-morbidity and urbanisation level. Cox proportional hazards regression analyses were performed to evaluate the subsequent risk of AD. RESULTS: Patients with CP had a higher prevalence of hyperlipidaemia, depression, traumatic brain injury and co-morbidities, as well as higher urbanisation levels, than those in the unexposed cohort (all p < 0.01). At the final follow-up, totals of 115 (1.24%) and 208 (1.11%) individuals in the CP exposed and unexposed groups, respectively, had developed AD. Patients with 10 years of CP exposure exhibited a higher risk of developing AD than unexposed groups (adjusted HR 1.707, 95% CI 1.152-2.528, p = 0.0077). CONCLUSIONS: Our findings demonstrate that 10-year CP exposure was associated with a 1.707-fold increase in the risk of developing AD. These findings highlight the need to prevent progression of periodontal disease and promote healthcare service at the national level.

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  • Non-specific chronic periodontitis has been related to increased AD risk, but only among individuals with greater than 10 years of exposure.

    “Non-specific chronic periodontitis has been related to increased AD risk, but only among individuals with greater than 10 years of exposure [76].”

    From What would it take to prove that a chronic infection is a causal agent in Alzheimer’s disease? (2025) · cites this paper as [76]

    The Discussion (page not available) reports a significant association between chronic periodontitis and AD only after 10 years of follow-up from the initial diagnosis; Results Table 2 shows the corresponding adjusted HR of 1.707. The study does not establish that participants had more than 10 years of periodontitis exposure, so the claim turns a follow-up interval into an exposure-duration threshold. (LLM, conf=0.86)

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References 45 · Cited by 359

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Authors
Chen, C.-K., Wu, Y.-T., & Chang, Y.-C.
Affiliations
  • Zuoying Armed Forces General Hospital (TW)
  • Tri-Service General Hospital (TW)
  • Chung Shan Medical University Hospital (TW)
Corresponding author
Chang, Yu-Chao
ORCID
Venue
Alzheimer's Research & Therapy
Publisher
Springer Science and Business Media LLC
Published
2017-08-08
Volume
9
Issue
1
Pages
56-56
ISSN
1758-9193 (ISSN-L)
DOI
10.1186/s13195-017-0282-6
PMC
PMC5547465
OpenAlex
W2740122261
Cited by
359
References
45
Citations by year
2026: 51 · 2025: 50 · 2024: 43 · 2023: 41 · 2022: 41 · 2021: 56 · 2020: 41 · 2019: 23 · 2018: 7 · 2017: 4
FWCI
16.85
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Alzheimer s Research & Therapy (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
Keywords
chronic periodontitis, Alzheimer's disease, periodontal disease, dementia risk, hyperlipidemia, depression, traumatic brain injury, comorbidities, urbanization
MeSH terms
Aged, Alzheimer Disease, Female, Follow-Up Studies, Humans, Male, Middle Aged, Retrospective Studies, Risk Factors, Rural Population, Taiwan, Urban Population, Comorbidity, Prevalence, Multivariate Analysis, Proportional Hazards Models, Kaplan-Meier Estimate, Chronic Periodontitis

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