牙齿与记忆：衰老过程中口腔健康与认知障碍的关联
Teeth and Memory: The Association between Oral Health and Cognitive Impairment during Aging
DOI: 10.12677/jcpm.2025.41061, PDF,   
作者: 刘雨芳, 张曦木*：重庆医科大学附属口腔医院牙周科口腔疾病与生物医学重庆市重点实验室，重庆市高校市级口腔生物医学工程重点实验室，重庆
关键词: 口腔健康；认知障碍；衰老；炎症；Oral Health； Cognitive Impairment； Aging； Inflammation
摘要: 随着全球人口老龄化趋势的加剧，主要波及老年人群认知障碍的发病率在全球不同地区均呈现上升趋势，这一现象与老年人免疫功能的减退和口腔卫生维护能力的下降密切相关，进而导致口腔功能受损和牙菌斑积累增加。本文阐述了衰老时口腔结构和功能的改变、微生物的变化、口腔疾病的发生发展特点。探讨了口腔健康不良对认知功能影响的途径。旨在强调重视老年人口腔健康对预防和延缓衰老过程中认知障碍发生发展的重要性，为后续进一步研究及干预策略制定提供参考依据。
Abstract: With the intensification of the global population aging trend, the incidence of cognitive impairment mainly affecting the elderly population is increasing in different regions of the world, which is closely related to the decline of immune function and oral health maintenance ability of the elderly, which in turn leads to the impairment of oral function and the increase of plaque accumulation. This article expounds the changes in oral structure and function, the changes in microorganisms, and the occurrence and development characteristics of oral diseases during aging. The pathways of the impact of poor oral health on cognitive function were explored. The purpose of this study is to emphasize the importance of paying attention to the oral health of the elderly to prevent and delay the occurrence and development of cognitive impairment in the aging process, and to provide a reference for further research and the formulation of intervention strategies.
文章引用：刘雨芳, 张曦木. 牙齿与记忆：衰老过程中口腔健康与认知障碍的关联[J]. 临床个性化医学, 2025, 4(1): 407-414. https://doi.org/10.12677/jcpm.2025.41061

参考文献

[1] Wei, T., Du, Y., Hou, T., Zhai, C., Li, Y., Xiao, W., et al. (2023) Association between Adverse Oral Conditions and Cognitive Impairment: A Literature Review. Frontiers in Public Health, 11, Article 1147026. [Google Scholar] [CrossRef] [PubMed]
[2] Daly, B., Thompsell, A., Sharpling, J., Rooney, Y.M., Hillman, L., Wanyonyi, K.L., et al. (2017) Evidence Summary: The Relationship between Oral Health and Dementia. British Dental Journal, 223, 846-853. [Google Scholar] [CrossRef] [PubMed]
[3] Lamster, I.B., Asadourian, L., Del Carmen, T. and Friedman, P.K. (2016) The Aging Mouth: Differentiating Normal Aging from Disease. Periodontology 2000, 72, 96-107. [Google Scholar] [CrossRef] [PubMed]
[4] Liu, B., Zhang, M., Chen, Y. and Yao, Y. (2014) Tooth Wear in Aging People: An Investigation of the Prevalence and the Influential Factors of Incisal/Occlusal Tooth Wear in Northwest China. BMC Oral Health, 14, Article No. 65. [Google Scholar] [CrossRef] [PubMed]
[5] Chan, A.K.Y., Tamrakar, M., Jiang, C.M., Lo, E.C.M., Leung, K.C.M. and Chu, C. (2021) Common Medical and Dental Problems of Older Adults: A Narrative Review. Geriatrics, 6, Article 76. [Google Scholar] [CrossRef] [PubMed]
[6] Lacoste-Ferré, M., Hermabessière, S., Jézéquel, F. and Rolland, Y. (2013) Oral Ecosystem in Elderly People. Gériatrie et Psychologie Neuropsychiatrie du Viellissement, 11, 144-150. [Google Scholar] [CrossRef] [PubMed]
[7] Gil-Montoya, J.A., Ponce, G., Sánchez Lara, I., Barrios, R., Llodra, J.C. and Bravo, M. (2013) Association of the Oral Health Impact Profile with Malnutrition Risk in Spanish Elders. Archives of Gerontology and Geriatrics, 57, 398-402. [Google Scholar] [CrossRef] [PubMed]
[8] The Human Microbiome Project Consortium (2012) Structure, Function and Diversity of the Healthy Human Microbiome. Nature, 486, 207-214. [Google Scholar] [CrossRef] [PubMed]
[9] Guo, L., Zhou, J., Xie, F., Lang, Q., Xu, Y., Chen, L., et al. (2024) The Profile of Oral Microbiome in Chinese Elderly Population Associated with Aging and Systemic Health Status. BMC Oral Health, 24, Article No. 895. [Google Scholar] [CrossRef] [PubMed]
[10] Feres, M., Teles, F., Teles, R., Figueiredo, L.C. and Faveri, M. (2016) The Subgingival Periodontal Microbiota of the Aging Mouth. Periodontology 2000, 72, 30-53. [Google Scholar] [CrossRef] [PubMed]
[11] Mougeot, J.C., Stevens, C.B., Paster, B.J., Brennan, M.T., Lockhart, P.B. and Mougeot, F.K.B. (2017) Porphyromonas gingivalis Is the Most Abundant Species Detected in Coronary and Femoral Arteries. Journal of Oral Microbiology, 9, Article 1281562. [Google Scholar] [CrossRef] [PubMed]
[12] Sabharwal, A., Stellrecht, E. and Scannapieco, F.A. (2021) Associations between Dental Caries and Systemic Diseases: A Scoping Review. BMC Oral Health, 21, Article No. 472. [Google Scholar] [CrossRef] [PubMed]
[13] Jiang, Q., Liu, J., Chen, L., Gan, N. and Yang, D. (2019) The Oral Microbiome in the Elderly with Dental Caries and Health. Frontiers in Cellular and Infection Microbiology, 8, Article 442. [Google Scholar] [CrossRef] [PubMed]
[14] Guiglia, R., Musciotto, A., Compilato, D., Procaccini, M., Russo, L., Ciavarella, D., et al. (2010) Aging and Oral Health: Effects in Hard and Soft Tissues. Current Pharmaceutical Design, 16, 619-630. [Google Scholar] [CrossRef] [PubMed]
[15] Eke, P.I., Wei, L., Borgnakke, W.S., Thornton‐Evans, G., Zhang, X., Lu, H., et al. (2016) Periodontitis Prevalence in Adults≥65 Years of Age, in the USA. Periodontology 2000, 72, 76-95. [Google Scholar] [CrossRef] [PubMed]
[16] López, R., Smith, P.C., Göstemeyer, G. and Schwendicke, F. (2017) Ageing, Dental Caries and Periodontal Diseases. Journal of Clinical Periodontology, 44, S145-S152. [Google Scholar] [CrossRef] [PubMed]
[17] Preshaw, P.M., Henne, K., Taylor, J.J., Valentine, R.A. and Conrads, G. (2017) Age‐Related Changes in Immune Function (Immune Senescence) in Caries and Periodontal Diseases: A Systematic Review. Journal of Clinical Periodontology, 44, S153-S177. [Google Scholar] [CrossRef] [PubMed]
[18] Gavriilidou, N.N. and Belibasakis, G.N. (2019) Root Caries: The Intersection between Periodontal Disease and Dental Caries in the Course of Ageing. British Dental Journal, 227, 1063-1067. [Google Scholar] [CrossRef] [PubMed]
[19] Gauthier, S., Reisberg, B., Zaudig, M., Petersen, R.C., Ritchie, K., Broich, K., et al. (2006) Mild Cognitive Impairment. The Lancet, 367, 1262-1270. [Google Scholar] [CrossRef] [PubMed]
[20] (2024) 2024 Alzheimer’s Disease Facts and Figures. Alzheimer’s & Dementia, 20, 3708-3821. [Google Scholar] [CrossRef] [PubMed]
[21] Zheng, H., Cagney, K. and Choi, Y. (2023) Predictors of Cognitive Functioning Trajectories among Older Americans: A New Investigation Covering 20 Years of Age-and Non-Age-Related Cognitive Change. PLOS ONE, 18, e0281139. [Google Scholar] [CrossRef] [PubMed]
[22] Franceschi, C. and Campisi, J. (2014) Chronic Inflammation (Inflammaging) and Its Potential Contribution to Age-Associated Diseases. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 69, S4-S9. [Google Scholar] [CrossRef] [PubMed]
[23] Zeng, L., Zong, Q., Xu, S., An, F., Ungvari, G.S., Bressington, D.T., et al. (2020) Oral Health in Patients with Dementia: A Meta‐Analysis of Comparative and Observational Studies. International Journal of Geriatric Psychiatry, 36, 467-478. [Google Scholar] [CrossRef] [PubMed]
[24] Krishnamoorthy, G., Narayana, A.I. and Balkrishanan, D. (2018) Mastication as a Tool to Prevent Cognitive Dysfunctions. Japanese Dental Science Review, 54, 169-173. [Google Scholar] [CrossRef] [PubMed]
[25] Nakamura, H., Noguchi-Shinohara, M., Ishimiya-Jokaji, M., Kobayashi, Y., Isa, M., Ide, K., et al. (2024) Brain Atrophy in Normal Older Adult Links Tooth Loss and Diet Changes to Future Cognitive Decline. npj Aging, 10, Article No. 20. [Google Scholar] [CrossRef] [PubMed]
[26] Chen, Y., Li, C., Fan, Y., Jiao, L., Silverman, M., Ishimaru, M., et al. (2023) Associations of Oral Health Status and Swallowing Function with Cognitive Impairment in the Aging Population: A Cross-Sectional Study. BMC Oral Health, 23, Article No. 912. [Google Scholar] [CrossRef] [PubMed]
[27] Lin, T., Wang, P., Lin, C. and Hung, S. (2024) Association of the Oral Microbiome with Cognitive Function among Older Adults: NHANES 2011-2012. The Journal of Nutrition, Health and Aging, 28, Article 100264. [Google Scholar] [CrossRef] [PubMed]
[28] Villalobos, V., Garrido, M., Reyes, A., Fernández, C., Diaz, C., Torres, V.A., et al. (2022) Aging Envisage Imbalance of the Periodontium: A Keystone in Oral Disease and Systemic Health. Frontiers in Immunology, 13, Article 1044334. [Google Scholar] [CrossRef] [PubMed]
[29] Dominy, S.S., Lynch, C., Ermini, F., Benedyk, M., Marczyk, A., Konradi, A., et al. (2019) Porphyromonas gingivalis in Alzheimer’s Disease Brains: Evidence for Disease Causation and Treatment with Small-Molecule Inhibitors. Science Advances, 5, eaau3333. [Google Scholar] [CrossRef] [PubMed]
[30] Khoury, R. and Grossberg, G.T. (2020) Deciphering Alzheimer’s Disease: Predicting New Therapeutic Strategies via Improved Understanding of Biology and Pathogenesis. Expert Opinion on Therapeutic Targets, 24, 859-868. [Google Scholar] [CrossRef] [PubMed]
[31] Krstic, D. and Knuesel, I. (2012) Deciphering the Mechanism Underlying Late-Onset Alzheimer Disease. Nature Reviews Neurology, 9, 25-34. [Google Scholar] [CrossRef] [PubMed]
[32] González-Sanmiguel, J., Schuh, C.M.A.P., Muñoz-Montesino, C., Contreras-Kallens, P., Aguayo, L.G. and Aguayo, S. (2020) Complex Interaction between Resident Microbiota and Misfolded Proteins: Role in Neuroinflammation and Neurodegeneration. Cells, 9, Article 2476. [Google Scholar] [CrossRef] [PubMed]
[33] Yang, I., Arthur, R.A., Zhao, L., Clark, J., Hu, Y., Corwin, E.J., et al. (2021) The Oral Microbiome and Inflammation in Mild Cognitive Impairment. Experimental Gerontology, 147, Article 111273. [Google Scholar] [CrossRef] [PubMed]
[34] Huang, X., Wei, P., Fang, C., Yu, M., Yang, S., Qiu, L., et al. (2024) Compromised Endothelial Wnt/β-Catenin Signaling Mediates the Blood-Brain Barrier Disruption and Leads to Neuroinflammation in Endotoxemia. Journal of Neuroinflammation, 21, Article No. 265. [Google Scholar] [CrossRef] [PubMed]
[35] Ye, N., Deng, B., Hu, H., Ai, Y., Liu, X., Zhou, S., et al. (2024) The Association between Oral Health and Mild Cognitive Impairment in Community-Dwelling Older Adults. Frontiers in Public Health, 12, Article 1464439. [Google Scholar] [CrossRef] [PubMed]
[36] Iwasaki, M., Kimura, Y., Ogawa, H., Yamaga, T., Ansai, T., Wada, T., et al. (2018) Periodontitis, Periodontal Inflammation, and Mild Cognitive Impairment: A 5‐Year Cohort Study. Journal of Periodontal Research, 54, 233-240. [Google Scholar] [CrossRef] [PubMed]
[37] Iwasaki, M., Yoshihara, A., Kimura, Y., Sato, M., Wada, T., Sakamoto, R., et al. (2016) Longitudinal Relationship of Severe Periodontitis with Cognitive Decline in Older Japanese. Journal of Periodontal Research, 51, 681-688. [Google Scholar] [CrossRef] [PubMed]
[38] Lei, S., Li, J., Yu, J., Li, F., Pan, Y., Chen, X., et al. (2023) Porphyromonas gingivalis Bacteremia Increases the Permeability of the Blood-Brain Barrier via the Mfsd2a/Caveolin-1 Mediated Transcytosis Pathway. International Journal of Oral Science, 15, Article No. 3. [Google Scholar] [CrossRef] [PubMed]
[39] Ma, X., Shin, Y., Yoo, J., Park, H. and Kim, D. (2023) Extracellular Vesicles Derived from Porphyromonas gingivalis Induce Trigeminal Nerve-Mediated Cognitive Impairment. Journal of Advanced Research, 54, 293-303. [Google Scholar] [CrossRef] [PubMed]
[40] Gong, T., Chen, Q., Mao, H., Zhang, Y., Ren, H., Xu, M., et al. (2022) Outer Membrane Vesicles of Porphyromonas gingivalis Trigger NLRP3 Inflammasome and Induce Neuroinflammation, Tau Phosphorylation, and Memory Dysfunction in Mice. Frontiers in Cellular and Infection Microbiology, 12, Article 925435. [Google Scholar] [CrossRef] [PubMed]
[41] Sanz, M., Herrera, D., Kebschull, M., Chapple, I., Jepsen, S., Berglundh, T., et al. (2020) Treatment of Stage I-III Periodontitis—The EFP S3 Level Clinical Practice Guideline. Journal of Clinical Periodontology, 47, 4-60. [Google Scholar] [CrossRef] [PubMed]
[42] Pelekos, G., Acharya, A., Eiji, N., Hong, G., Leung, W.K. and McGrath, C. (2020) Effects of Adjunctive Probiotic L. reuteri Lozenges on S/RSD Outcomes at Molar Sites with Deep Pockets. Journal of Clinical Periodontology, 47, 1098-1107. [Google Scholar] [CrossRef] [PubMed]
[43] Schwahn, C., Frenzel, S., Holtfreter, B., Van der Auwera, S., Pink, C., Bülow, R., et al. (2021) Effect of Periodontal Treatment on Preclinical Alzheimer’s Disease—Results of a Trial Emulation Approach. Alzheimer’s & Dementia, 18, 127-141. [Google Scholar] [CrossRef] [PubMed]