TY - JOUR
T1 - White Blood Cell Count Mediates the Association Between Periodontal Inflammation and Cognitive Performance Measured by Digit Symbol Substitution Test Among Older U.S. Adults
AU - Li, An
AU - Chen, Yuntao
AU - van der Sluis, Luc W M
AU - Schuller, Annemarie A
AU - Tjakkes, Geerten-Has
N1 - © The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2021/7
Y1 - 2021/7
N2 - BACKGROUND: Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function.METHODS: We conducted a cross-sectional analysis of 766 participants aged > 60 years and who had complete periodontal and cognitive examinations in the NHANES 2001-2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen.RESULTS: Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = -0.091; 95% CI = -0.174 to -0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = -0.059; 95% CI = -0.087 to -0.031) and mediated 20.3% of the total association.CONCLUSION: Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.
AB - BACKGROUND: Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function.METHODS: We conducted a cross-sectional analysis of 766 participants aged > 60 years and who had complete periodontal and cognitive examinations in the NHANES 2001-2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen.RESULTS: Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = -0.091; 95% CI = -0.174 to -0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = -0.059; 95% CI = -0.087 to -0.031) and mediated 20.3% of the total association.CONCLUSION: Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.
U2 - 10.1093/gerona/glaa223
DO - 10.1093/gerona/glaa223
M3 - Article
C2 - 32886763
VL - 76
SP - 1309
EP - 1315
JO - The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences
JF - The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences
SN - 1079-5006
IS - 7
ER -