Association of periodontitis and tooth loss with cognitive decline in the older adults - a systematic review

Afsary Jahan Khan; Iffat Rahman; Hasina Akhtar Beg; Shahinur Akter; Rashida Haque; Dil Tahmina Monsur; Haslina Rani; Tuti Ningseh Mohd Dom

doi:10.1186/s12903-026-08310-w

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Association of periodontitis and tooth loss with cognitive decline in the older adults - a systematic review

Journal article

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Association of periodontitis and tooth loss with cognitive decline in the older adults - a systematic review

Afsary Jahan Khan, Iffat Rahman, Hasina Akhtar Beg, Shahinur Akter, Rashida Haque, Dil Tahmina Monsur, Haslina Rani and Tuti Ningseh Mohd Dom

BMC oral health, Vol.26(1), 811

2026

DOI: https://doi.org/10.1186/s12903-026-08310-w

PMID: 41965638

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Abstract

Aged

Cognitive Dysfunction - epidemiology

Cognitive Dysfunction - etiology

Humans

Periodontitis - complications

Tooth Loss - complications

The increasing global burden of dementia highlights the importance of identifying factors that may contribute to cognitive decline in later life. Growing evidence suggests that chronic oral conditions, particularly periodontitis (PD) and tooth loss, may be associated with Alzheimer's disease (AD) and related dementias. This study synthesizes current observational evidence on the association between PD, tooth loss, and cognitive impairment (CI) among older adults. A comprehensive literature search was conducted in PubMed, the Cochrane Library, Embase, Scopus, and Google Scholar for English-language studies published between 2010 and 2025. Cross-sectional and longitudinal cohort studies examining associations between PD, tooth loss, and CI were included. Study selection, data extraction, and quality assessment were performed in accordance with PRISMA 2020 guidelines. Thirteen studies met the inclusion criteria, with sample sizes ranging from 40 participants to over 500,000 individuals in large population-based cohorts. Most studies focused on adults aged ≥ 50 years, particularly those aged 60 years and above. Periodontal status, tooth loss, and cognitive outcomes were assessed using heterogeneous diagnostic methods. Most studies reported significant associations between PD or tooth loss and CI, dementia, or AD. Periodontal treatment appeared protective in several studies, although some associations weakened after adjustment for confounders. The findings support PD and tooth loss are consistently associated with adverse cognitive outcomes, although causal relationships cannot be established due to methodological heterogeneity and residual confounding. Integrating oral health care into geriatric and dementia-prevention strategies may help preserve cognitive function and improve quality of life among older adults.

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Title: Association of periodontitis and tooth loss with cognitive decline in the older adults - a systematic review
Authors/Creators: Afsary Jahan Khan - National University of Malaysia
Iffat Rahman - University of Rajshahi
Hasina Akhtar Beg - Lincoln University College
Shahinur Akter - Bangladesh Medical University
Rashida Haque - University of Dhaka
Dil Tahmina Monsur - Murdoch University
Haslina Rani - National University of Malaysia
Tuti Ningseh Mohd Dom - Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia. tutinin@ukm.edu.my
Publication Details: BMC oral health, Vol.26(1), 811
Publisher: Springer Nature
Number of pages: 18
Identifiers: 991005882550407891
Murdoch Affiliation: School of Nursing
Language: English
Resource Type: Journal article

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