Folate mediates cognitive impairment of aged people with periodontitis

Abstract

Abstract Aims To examine the mediation of folate on the periodontitis-promoted cognitive impairment (CI) in the elderly population. Materials and Methods Data for this cross-sectional population-based study was obtained from the National Health and Nutrition Examination Survey (NHANES), 2011–2014 database. Associations between periodontitis and cognitive scores, exogenous and endogenous folate levels were estimated by propensity score weighted regression models. Natural effect models were applied to estimate the mediation effect of folate for the periodontitis-cognition relationship. Results Out of the 1966 participants, 869 (44.2%) had periodontitis. The periodontitis group has lower cognitive scores and dietary supplement, serum total, and RBC folate levels. The mediation effect of dietary supplement folate for periodontitis-general cognition score association was significant with mediation proportions of 8.4%. The mediation effects of serum total folate and RBC folate for periodontitis-general cognition score were both significant with mediation proportions of 9.1%. Notably, periodontitis cases with dietary supplement folate or high dietary intake folate had significantly higher general cognition scores than those of periodontitis cases without dietary supplement folate or with low dietary intake folate. Conclusions Exogenous folate supplementation can alleviate periodontitis-related CI in the elderly population. Serum and RBC folate are key markers for alleviating periodontitis-related CI.