Periodontitis and Mild Cognitive Impairment Risk in Diabetic Patients: Insights from an Exploratory Analysis

Background: Cognitive impairment, including dementia, is a growing global health challenge, particularly as populations age. Previous studies have identified periodontitis and diabetes mellitus as modifiable risk factors for dementia, potentially linked through systemic inflammation. We hypothesize that systemic inflammation induced by periodontitis may contribute to an increased risk of cognitive impairment. Therefore, this study aims to explore the correlation between periodontal inflammation and the risk of Mild Cognitive Impairment (MCI) in type II diabetes mellitus. Materials and Methods: Baseline data analysis was performed as an analytical cross-sectional study among diabetic patients aged 40 and older who met the inclusion criteria from a randomized controlled trial (RCT) from November 2020 to April 2023. Periodontal inflammation was measured using the Periodontal Inflamed Surface Area (PISA) score. The MCI risk score was calculated using blood samples to assess eight protein markers correlated to MCI (ApoA1, TTR, C3, Albumin, ApoC1, A1BG, A2AP, and HPX). Fisher's exact test and Spearman's correlation analysis were performed. Results: 29 T2DM patients were included in the study. There was a significant difference in MCI risk score between the low and high PISA levels group (p < 0.05). Patients with low PISA scores tend to have a lower risk of MCI (p < 0.00). Variables correlated with MCI risk are PISA (ρ = 0.37; p < 0.05) and TTR levels (ρ = -0.51; p < 0.01). ApoA1 has a correlation with CRP (ρ = 0.42; p < 0.05) and IL-6 (ρ = 0.43; p < 0.05), and C3 (ρ = 0.42; p < 0.05) was correlated with CRP. Conclusions: This study found that periodontal inflammation status has a potential correlation to the risk of MCI.