Abstract:

Background: Periodontitis is a hypothesized risk factor for cognitive impairment. Manyprior studies lack information on biological markers of Alzheimer’s disease and related dementias (ADRD) risk or genetic risk markers. We assessed the association betweenperiodontitis, biological markersofADRDrisk,andcognitive test performance with robust adjustment for risk factors including high risk genotypes for ADRD.
Methods: We use data from the United States High School and Beyond (HS&B:80) cohort study, a nationally representative sample of ∼26,830 people enrolledduringhighschoolin1980throughmidlifein2021.Baselinedatainclude information about educational contexts, opportunities, and outcomes; early life circumstances; and demographic group memberships. HS&B:80 data from 2021 include indicators of periodontal disease diagnosis history, blood biomarkers of ADRDrisk, andmultiple measures of cognitive functioning. We calculated false discovery rates (FDR) to account for multiple comparisons.
Results: Our analyses included 13,950 HS&B:80 panelists (mean age 58 years), among whom 15.2% reported a history of periodontal disease. Periodontal disease wasassociated with lowergeneral cognitivefunctioning and scores on some domain-specific cognitive tasks; it was also associated with increased levels of pTau-181 and C-reactive protein. We find no evidence of heterogeneity in associations by sex, race and ethnicity, or number of apolipoprotein E (APOE) ε4 alleles. Only working memory attained a FDR < 10%after multiple comparisons adjustment.
Conclusion: In this large, diverse, population-representative, community dwelling sample, self-reported periodontal disease was cross-sectionally associated with cognitive functioning at age ∼60 and some biomarkers of ADRD