Inflammation in the periodontium in old age and 21-year mortality

Objectives: Inflammatory processes have been implicated as predictors of or contributors to onset of disability and mortality in aging. This association has been proposed to be caused by altered cytokine profiles due to aging of the innate immune system and/or non-immune cells and/or age-related changes in body composition. The objective was to examine whether inflammation in the periodontium at age 70 is associated with mortality during 21-year follow-up. Methods: The study is based on the Glostrup Aging Study of the 1914-population. A total of 342 dentate men and women participated in the clinical oral health examination of the 70-year study, which was conducted in 1984. Severe periodontal inflammation was measured for all teeth present as the number of teeth with inflammation and periodontal pocket depths ³ 6 mm. Mortality data were obtained from the Danish Death Register at 21-year follow-up. The Cox proportional hazard regression model was used. Results: The analyses showed that severe periodontal inflammation in at least three teeth at age 70 was marginally related to mortality during 21-year follow-up (crude hazard ratio 1.17; 95% CI 0.91-1.78). The estimate increased slightly when adjusted by gender, income, fatigue, arteriostenosis and smoking (adjusted hazard ratio 1.31; 95% CI 0.93-1.84). Conclusion: The findings support the hypothesis that inflammation in the periodontium in early old age may be associated with an increased risk of mortality in old old age. The results suggest the need for further study of these relationships.