老年人口腔健康状况与认知功能纵向队列研究的meta分析

Longitudinal cohort study of oral health status and cognitive function in the elderly:A meta-analysis

目的采用meta分析探讨口腔健康状况与认知功能障碍发生风险的相关性。方法计算机检索PubMed、Web of Science、EMBASE、Scopus、知网、中国生物医学文献数据库、万方、维普、读秀数据库中关于口腔健康状况与认知功能相关性的队列研究,检索时限均为建库至2023年8月。由2名研究者独立筛选文献、提取资料并评价纳入研究的文献质量,采用RevMan 5.3及Stata 17.0软件进行meta分析。结果共纳入34个队列,meta分析结果显示,与口腔健康状况好的老年人相比口腔健康状况差的老年人发生认知功能障碍的风险增加[RR=1.31,95%CI(1.18~1.46),P<0.01]。亚组分析结果显示,牙周炎/牙周病、后咬合支撑、牙列状态、牙齿缺失亚组差异均有统计学意义(P<0.05),而在口腔衰弱亚组中,差异无统计学意义[RR=1.32,95%CI(0.96~1.81),P=0.09],口腔健康状况与认知障碍发生风险在随访时间>10年亚组差异无统计学意义[RR=1.01,95%CI(0.83~1.23),P=0.90];在随访时间≤10年亚组差异有统计学意义[RR=1.48,95%CI(1.32~1.67),P<0.001];口腔健康状况与认知障碍发生风险在中等质量亚组差异无统计学意义[RR=1.05,95%CI(0.91~1.20),P=0.51];在高质量亚组则差异有统计学意义[RR=1.35,95%CI(1.21~1.51),P<0.01]。结论口腔健康状况与认知功能障碍发生风险具有相关性。

Objective To explore the correlation between oral health status and the risk of cognitive dysfunction by meta-analysis.Methods Cohort studies on the correlation between oral health status and cognitive function from inception to August 2023 were searched in PubMed,Web of Science,EMBASE,Scopus,Chinese National Knowledge Infrastructure(CNKI),China Biomedical Literature Database(CBM),Wanfang,VIP and Duxiu databases.Two reviewers independently screened literatures,extracted data and evaluated the quality of included studies.Meta-analysis was performed using RevMan 5.3 and Stata 17.0 software.Results A total of 34 cohorts were included.The results of meta-analysis showed that the risk of cognitive impairment in the elderly with poor oral health status was significantly higher than that in the elderly with good oral health status(RR=1.31,95%CI 1.18-1.46,P<0.01).The results of subgroup analysis showed that there were significant differences in periodontitis disease,posterior occlusal support,dentition status,and tooth loss(P<0.05),but there was no significant difference in the oral frailty(RR=1.32,95%CI 0.96-1.81,P=0.09).There was no significant difference in the risk of oral health status and cognitive impairment in the subgroup with a follow-up time>10 years(RR=1.01,95%CI 0.83-1.23,P=0.90),but a significant difference was detected in the subgroup with a follow-up time≤10 years(RR=1.48,95%CI 1.32-1.67,P<0.001).There was no significant difference in the risk of oral health status and cognitive impairment in the moderate quality subgroup(RR=1.05,95%CI 0.91-1.20,P=0.51),but a significant difference was detected in the high quality subgroup(RR=1.35,95%CI 1.21-1.51,P<0.01).Conclusion Oral health status is associated with the risk of cognitive dysfunction.