ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Alzheimer's Disease and Related Dementias
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1524268
This article is part of the Research TopicPeriodontal Disease and Systemic Health: Preventive Strategies and ManagementView all 4 articles
The effect of periodontal status in the associations between socioeconomic status and cognitive performance: a mediation analysis in older adults
Provisionally accepted
- 1The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
- 2The 963 hospital of the PLA joint logistics support force, Jiamusi, Heilongjiang Province, China
- 3Department of Cardiology, National Center of Gerontology, Institute of Geriatric Medicine, Beijing Hospital, Chinese Academy of Medical Sciences, Beijing, China
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Introduction: The aim of this study is to analyse the association of socioeconomic status (SES) with cognitive performance, and the mediation effect of periodontal status in this relationship in the National Health and Nutrition Examination Survey (NHANES) database from 2011–2014.Methods: The SES was evaluated based on poverty-income ratio (PIR), occupation, educational level, and health insurance using latent class analysis. Multivariable logistic regressions were used to determine the association of cognitive performance, examined by Consortium to Establish a Registry for Alzheimer’s disease (CERAD) test, Animal Fluency test (AFT), and Digit Symbol Substitution Test (DSST), with SES, attachment loss (AL) and probing depth (PD). Multivariable linear regressions were used to explore the association of mean AL and mean PD with SES. A mediation analysis was conducted to examine the impact of mean AL and mean PD on the relationship between SES and cognitive performance.Results: The study included 1812 participants aged 60 years or older. In the fully adjusted model, SES showed a positive correlation with all three cognitive tests. Meanwhile, mean AL (odds ratio [OR] = 1.61; 95% confidence interval [CI]: 1.33 to 1.95) and mean PD (OR = 2.14; 95% CI: 1.54 to 2.96) were inversely related to the DSST scores, accounting for 12.17% and 6.91% of the relationship between SES and DSST, respectively. The mediation effect of periodontal status in this association was significant only in non-HSB participants or in younger participants.Conclusion: SES was negatively associated with periodontal status in older adults in the United States. Furthermore, the link between SES and cognitive performance can be partially explained by periodontal status.
Keywords: Socioeconomic status, Periodontal status, cognitive performance, NHANES, elderly adults
Received: 07 Nov 2024; Accepted: 28 May 2025.
Copyright: © 2025 Zhang, Xiang, Zhang, Chen and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wei Liu, The Second Affiliated Hospital of Air Force Medical University, Xi’an, China
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