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Objective:To analyze the modifiable risk factors for early-onset Alzheimer's disease (EOAD), and provide evidence for primary prevention of EOAD.Methods:Forty patients with EOAD, admitted to our hospital from January 2015 to April 2020, were selected as EOAD group, and 120 healthy controls accepted physical examination and matched with EOAD patients in age, gender and education level were selected. Demographic characteristics and clinical data of patients from the EOAD group and subjects from the control group were compared retrospectively, and multivariate Logistic regression was used to analyze the independent risk factors for onset of EOAD.Results:As compared with the control group, the EOAD group had significantly higher proportion of patients with hypertension, non-traumatic tooth loosening or loss, history of traumatic brain injury, hearing impairment, chronic stress and/or anxiety, and sleep disorder ( P<0.05). The results of multivariate Logistic regression analysis showed that hypertension ( OR=4.559, 95%CI=1.523-13.643, P=0.007), non-traumatic loss or loosing of tooth ( OR=5.345, 95%CI=1.989-14.346, P=0.001), hearing impairment ( OR=9.336, 95%CI=2.033-27.850, P=0.000), chronic stress and/or anxiety ( OR=7.375, 95%CI=2.612-20.822, P=0.000), and sleep disorder ( OR=4.875, 95%CI=1.520-15.625, P=0.002) were independent risk factors for onset of EOAD. Conclusion:Hypertension, non-traumatic loss or loosing of tooth, hearing impairment, chronic stress and/or anxiety, and sleep disorders are risk factors for onset of EOAD; the screening and intervention of these risk factors can be used as a primary prevention strategy for EOAD.
RÉSUMÉ
Antecedentes: La periodontitis crónica asociada a la placa bacteriana tiene factores de riesgo modificables e inmodificables que deben tenerse en cuenta en su prevención y control. Objetivo: Analizar la evidencia disponible sobre los factores de riesgo modificables e inmodificables de la periodontitis crónica con el fin de escribir guías de manejo clínico. Métodos: Se realizó una búsqueda sistemática de la literatura en tres bases de datos (PubMed, LiLACS y Embase) usando la siguiente combinación de términos del Medical Subejct Headings de Medline: "risk indicator OR risk factor AND chronic periodontitis". También se buscaron artículos y literatura gris en Google Académico. Se incluyeron estudios de corte transversal, casos y controles, longitudinales, ensayos clínicos controlados y revisiones generales y sistemáticas de la literatura. Se efectuó una revisión narrativa sobre el tema con las referencias más relevantes encontradas. Resultados: Se analizaron 39 artículos que cumplieron con los criterios de la búsqueda. Entre los factores de riesgo modificables se encontraron: diabetes no controlada, obesidad, estrés, tabaquismo y placa bacteriana. Los factores de riesgo inmodificables hallados fueron: cambios hormonales, infección por VIH, neutropenia, edad, sexo, raza y genética. Los dos factores de riesgo más frecuentemente asociados, además de la placa bacteriana, fueron diabetes y tabaquismo. Conclusiones: El control de la periodontitis crónica debe basarse no solo en el control de la placa bacteriana sino también en la prevención mediante la identificación temprana y el control de factores de riesgo para evitar la aparición o el avance de esta enfermedad.
Background: Dental-plaque associated chronic periodontitis is influenced by modifiable and non-modifiable risk factors that must be addressed through preventive and corrective treatment. Purpose: To analyze available evidence on modifiable and non-modifiable risk factors of chronic periodontitis in order to write clinical management guidelines. Methods: A systematic search of literature was conducted in three databases (PubMed, LiLACS, and Embase) using the following combination of terms from the Medical Subject Headings: "risk indicator OR risk factor AND chronic periodontitis." Other articles and gray literature were search in Google Scholar. The search included cross-sectional, cohort, and case control studies, controlled clinical trials, and general and systematic literature reviews. A narrative review was conducted with the most relevant articles found. Results: 39 articles met the search criteria. Modifiable risk factors found were: non-controlled diabetes, obesity, stress, smoking, and dental plaque. Non-modifiable factors were: hormonal changes, HIV infection, neutropenia, age, sex, race, and genetics. Besides dental plaque, the two most frequently associated factors were diabetes and smoking. Conclusion: The treatment of chronic periodontitis must focus, in addition to controlling dental plaque, on early detection prevention and risk-factor control to avoid the occurrence and advance of this type of disease.