07:44pm Tuesday 21 January 2020

Periodontitis Found to be Associated With Cognitive Impairment Among Older Adults

NEW YORK (January 12, 2010) Exposure to the common pathogen causing periodontitis is linked to poor performance on cognitive tasks among older individuals, according to a study offering preliminary evidence that periodontitis is a potential risk factor for dementia. This association has been found in a new research study led by James Noble, M.D., assistant professor of clinical neurology at the Columbia University Medical Center Affiliation at Harlem Hospital, in collaboration with physicians at Columbia University Medical Center.

There have been studies and research that have looked into the correlation between oral health, stroke and shared risk factors between stroke and dementia, but little or no studies have delved into the dental world, specifically periodontitis, as it relates to cognition,” Dr. Noble said. I think that further exploration of these relationships are warranted because no definitive conclusions can be drawn yet. Nobody has yet to disprove the dentist’s typical remarks, ‘brush and floss.’”

A dental hygienist flosses a patient’s teeth
during a periodic tooth cleaning.

In findings published in the Journal of Neurology, Neurosurgery, and Psychiatry, the investigators assessed the relationships between exposure to periodontal pathogens and performance on cognitive tasks in over 2,000 participants over the age of 60. Data were analyzed from the Third National Health and Nutrition Examination Survey, a nationally representative study among older adults.

“Inflammation has been linked to Alzheimer’s and other forms of dementia, and inflammation is a key element of periodontal disease, so it stands to reason that poor oral health can be associated with failing cognitive function,” added Panos N. Papapanou, DDS, Ph.D., Director of the Division of Periodontics at Columbia’s College of Dental Medicine. “Putting aside language and speech, the brain and the mouth are connected in more ways than one.”


James Noble, M.D.
Credit: Eileen Barroso

Rather than using dental examinations, the study explored measurements of an immune response to periodontal bacteria in the bloodstream as a marker for periodontitis. An association was found between periodontitis and impaired cognition including delayed memory and concentration. These findings remained robust after considering vascular and socio-demographic risk factors often associated with stroke, dementia, and periodontitis. Some of the findings suggested that patients with either chronic or severe periodontitis were at highest risk for these changes.

“Oral health continues to be a major health issue in Harlem and in similar communities where historically, there has been little or no access to dental care,” said Dr. James King, assistant clinical professor in the Columbia University College of Dental Medicine and the Director of Dentistry at Harlem Hospital Center. “A link between oral health and cardiovascular disease has already been established. Dr. Noble and his collaborators have found a potential new link between neurological conditions and a disease like periodontitis.”

The study, originally published in the November 2009 issue of the Journal of Neurology, Neurosurgery, and Psychiatry, further supports a growing body of literature that finds a potential connection between stroke and dementia, periodontitis and stroke, and perhaps periodontitis and dementia.


Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians & Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree. Among the most selective medical schools in the country, the school is home to the largest medical research enterprise in New York City and state, and one of the largest in the country. For more information, please visit www.cumc.columbia.edu.

Columbia University Medical Center – The Affiliation at Harlem Hospital is a team of over 500 health professionals and administrative staff dedicated to serving the healthcare needs of Central and West Harlem.  All physicians are appointed as faculty through Columbia University Medical Center and fulfill the mission of providing the utmost in patient care, resident teaching, and clinical research to the Harlem community.

Harlem Hospital Center has been a bedrock of the Harlem community since 1887. The hospital provides a wide range of medical, surgical, diagnostic, therapeutic and family support services to the residents of Central Harlem, West Harlem, Washington Heights and Inwood. Harlem is the largest hospital in the area, providing more than 90 specialized ambulatory care services, as well as dentistry and oral surgery, behavioral health services, and community substance abuse treatment. Harlem Hospital is a teaching institution affiliated with the College of Physicians and Surgeons at Columbia University since 1962. http://www.nyc.gov/html/hhc/html/facilities/harlem.shtml


Alex Lyda
(212) 305-0820


David Robbins
(212) 939-1378

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