Dementia and Alzheimer’s disease (AD) are proposed to be comorbid with periodontitis (PD). It is unclear whether PD is associated with dementia and AD independent of confounding factors. We aimed at identifying the relationship between the longitudinal risk of developing PD in a cohort of patients with dementia and AD who did not show any signs of PD at baseline. In this retrospective cohort study, 8,640 patients with dementia without prior PD were recruited, and 8,640 individuals without dementia history were selected as propensity score–matched controls. A Cox proportional hazard model was developed to estimate the risk of developing PD over 10 y. Cumulative probability was derived to assess the time-dependent effect of dementia on PD. Of the 8,640 patients, a sensitivity test was conducted on 606 patients with AD-associated dementia and 606 non-AD propensity score–matched controls to identify the impact of AD-associated dementia on the risk for PD. Subgroup analyses on age stratification were included. Overall 2,670 patients with dementia developed PD. The relative risk of PD in these patients was significantly higher than in the nondementia group (1.825, 95% CI = 1.715 to 1.942). Cox proportional hazard models showed that patients with dementia were more likely to have PD than individuals without dementia (adjusted hazard ratio = 1.915, 95% CI = 1.766 to 2.077, P < 0.0001, log-rank test P < 0.0001). The risk of PD in patients with dementia was age dependent (P values for all ages <0.0001); younger patients with dementia were more likely to develop PD. The findings persisted for patients with AD: the relative risk (1.531, 95% CI = 1.209 to 1.939) and adjusted hazard ratio (1.667, 95% CI = 1.244 to 2.232; log-rank test P = 0.0004) of PD in patients with AD were significantly higher than the non-AD cohort. Our findings demonstrated that dementia and AD were associated with a higher risk of PD dependent of age and independent of systemic confounding factors.

痴呆和阿尔茨海默病 (AD) 被认为与牙周炎 (PD) 并存。目前尚不清楚 PD 是否独立于混杂因素与痴呆和 AD 相关。我们的目的是确定一组痴呆患者和基线时未显示任何 PD 迹象的 AD 患者发生 PD 的纵向风险之间的关系。在这项回顾性队列研究中，招募了 8,640 名既往没有 PD 的痴呆患者，并选择了 8,640 名没有痴呆病史的个体作为倾向评分匹配的对照。开发了 Cox 比例风险模型来估计 10 年内发生 PD 的风险。推导出累积概率来评估痴呆对 PD 的时间依赖性影响。在 8,640 名患者中，对 606 名患有 AD 相关痴呆症的患者和 606 名非 AD 倾向评分匹配的对照组进行了敏感性测试，以确定 AD 相关痴呆症对 PD 风险的影响。包括年龄分层的亚组分析。总共有 2,670 名痴呆患者发展为 PD。这些患者的 PD 相对风险显着高于非痴呆组（1.825，95% CI = 1.715 至 1.942）。Cox 比例风险模型显示，患有痴呆症的患者比没有痴呆症的人更容易患 PD（调整后的风险比 = 1.915，95% CI = 1.766 至 2.077，这些患者的 PD 相对风险显着高于非痴呆组（1.825，95% CI = 1.715 至 1.942）。Cox 比例风险模型显示，患有痴呆症的患者比没有痴呆症的人更容易患 PD（调整后的风险比 = 1.915，95% CI = 1.766 至 2.077，这些患者的 PD 相对风险显着高于非痴呆组（1.825，95% CI = 1.715 至 1.942）。Cox 比例风险模型显示，患有痴呆症的患者比没有痴呆症的人更容易患 PD（调整后的风险比 = 1.915，95% CI = 1.766 至 2.077，P < 0.0001，对数秩检验P < 0.0001）。痴呆患者的 PD 风险具有年龄依赖性（所有年龄段的P值 <0.0001）；年轻的痴呆患者更容易患上帕金森病。AD 患者的研究结果仍然存在： PD 患者的相对风险（1.531，95% CI = 1.209 至 1.939）和调整后的风险比（1.667，95% CI = 1.244 至 2.232；时序检验 P = 0.0004 ） AD 明​​显高于非 AD 队列。我们的研究结果表明，痴呆和 AD 与较高的 PD 风险相关，该风险依赖于年龄并且独立于全身混杂因素。