Tooth Loss and Vascular Cognitive Impairment in Acute Stroke Patients

Abstract

Objective: Recent studies show that tooth loss may be associated with cognitive impairment and dementia. Vascular cognitive impairment is a common consequence of ischemic stroke. This cross-sectional study investigated the association of tooth loss with vascular cognitive impairment in patients with acute stroke. Method: 161 subjects with acute ischemic stroke were recruited from a group of 1,298 patients who were admitted to a Stroke Unit at the affiliated Yuebei People's Hospital of Shantou University Medical College. After admission, medical fasting blood tests were undertaken within 24 hours and the number of teeth present was recorded within seven days. Cognitive impairment was evaluated with the Chinese version of Montreal Cognitive Assessment (MoCA) within three days. Result: A receiver-operating characteristic curve showed that the ideal cut-point of tooth loss that could maximize its association with vascular cognitive impairment was 7 that generated the sensitivity and specificity of 61.2% and 73.2%, respectively. The patients who lost 8 to 28 teeth exhibited lower MoCA values as compared to those with loss of ≤ 7 teeth (13.2±6.6 vs. 17.3±6.0, p<0.001). Logistic regression analysis showed that loss of 8-28 teeth (OR=6.5, 95% CI: 2.2-18.9, p=0.001), low-density lipoprotein, diabetes, stroke history and income were significantly related with vascular cognitive impairment (MoCA<20.0). Conclusion: The present study suggests that multiple tooth loss (≥ 8 teeth) may be a risk factor of vascular cognitive impairment in patients with acute ischemic stroke. Further longitudinal study is warranted to support the current findings and elaborate the clinical implications. Supported in part by the Modern Dental Laboratory/HKU Endowment Fund to LJJ.

This abstract is based on research that was funded entirely or partially by an outside source: Supported in part by the Modern Dental Laboratory/HKU Endowment Fund to LJJ