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認知症患者における歯周病治療と死亡率との関連:集団ベースの後方視的コホート研究(2002~2018年)
Association of periodontal disease treatment with mortality in patients with dementia: a population-based retrospective cohort study (2002-2018).
PMID: 38438421
抄録
認知症は、世界的に主要な死因の1つである。本研究では、認知症患者における歯周病治療と死亡リスクとの関連を分析した。分析データは、2002年から2018年の国民健康保険公団の請求データと韓国統計庁の死亡登録とをリンクさせて得た。研究期間中、65歳以上の認知症患者1,131,406人が歯科治療を受けていた。時間依存Cox比例ハザードモデルを実施した。認知症患者の死亡率は約10%であった。歯周治療を受けた患者の17年累積生存率は83.5%、未治療の患者の17年累積生存率は71.5%であった。歯周治療群の粗ハザード比は非歯周治療群の約2倍であった(1.99;P<0.001)。さらに,社会人口統計学的変数と系統的慢性疾患で調整した回帰モデルでは,非歯周病群の死亡リスクは歯周病群の死亡リスクの約1.83倍であった(P<0.00).これらの知見は,予防的歯周治療が認知症高齢者の死亡リスクを低下させる可能性を示唆している.
Dementia is one of the leading causes of death worldwide. In this study, we analyzed the association of periodontal treatment with the risk of death in patients with dementia. The analyzed data were obtained by linking the National Health Insurance Corporation claims data between 2002 and 2018 to the Statistics Korea death registry. In total, 1,131,406 patients with dementia aged ≥ 65 years had undergone dental treatment during the study period. Time-dependent Cox proportional hazards model was performed. The mortality rate was approximately 10% among the patients with dementia. The 17-years cumulative survival rates for patients who received periodontal treatment and their untreated counterparts were 83.5% and 71.5%, respectively. The crude hazard ratio of the periodontal group was approximately twice as high as that of the non-periodontal group (1.99; P < 0.001). Furthermore, in the regression model that was adjusted for socio-demographic variables and systematic chronic diseases, the risk of death in the non-periodontal group was approximately 1.83 times higher than that of the periodontal group (P < 0.00). These findings suggest that preventive periodontal treatment may decrease mortality risk in older people with dementia.