White Blood Cell Count Mediates the Association Between Periodontal Inflammation and Cognitive Performance Measured by Digit Symbol Substitution Test Among Older U.S. Adults

作者：An Li, Yuntao Chen, Luc W. M. van der Sluis, A.A. Schuller, Geerten‐Has E. Tjakkes · 发表于：The Journals of Gerontology Series A · 年份：2020 · DOI：10.1093/gerona/glaa223 · 被引用次数：54 · 研究领域：Oral microbiology and periodontitis research、Salivary Gland Disorders and Functions、Gut microbiota and health

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 completed periodontal and cognitive examinations in the National Health and Nutrition Examination Survey (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% confidence interval [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 associa...