Abstract
The authors searched Medline via PubMed, Scopus,CINAHL, Web of Science, andPsycINFOfor relevant studies published until April 2022. Longitudinal studies that assessed periodontal health as the exposure and cognitive decline and/or dementia as the outcome were included. Case reports, reviews, cross-sectional studies, and animal studies were excluded. DATA EXTRACTIONAND SYNTHESIS: Two authors independently reviewed studies for inclusion,extracted data, and assessed study quality. Meta-analysis was conducted to generatepooled odds ratios(ORs) for cognitive decline andhazard ratios(HRs) for dementia. Sources of heterogeneity were explored throughsubgroup analyses. A total of 24 studies were included for cognitive decline and 23 for dementia. Poor periodontal health was associated with increased odds of cognitive decline (OR = 1.23; 95% CI: 1.05-1.44) and dementia (HR = 1.21; 95% CI: 1.07-1.38).Tooth lossalso appeared to increase the risk independently. However, significant heterogeneity existed between studies. Poor periodontal health may increase the risk of cognitive decline and dementia, but the quality of evidence was low. Further high-quality, longitudinal studies withstandardized assessmentsare needed to establish causality.
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