Kaye, ElizabethOrtiz, Maria Cristina2025-07-232025-07-232025https://hdl.handle.net/2144/507622025INTRODUCTION: Previous evidence suggests a potential link between periodontal disease and cognitive impairment, but little is known about how this association may differ across racial and ethnic groups. Understanding these differences is critical for addressing disparities in both oral and cognitive health among diverse populations in the United States. METHODS: This study analyzed data from 2,139 adults aged 65 and older using NHANES 2011–2014. Participants underwent full-mouth periodontal exams and cognitive assessments through four standardized tests (CERAD-IR, CERAD-DR, AFT, and DSST). Periodontal disease was classified into no/mild, moderate, or severe. Multivariable logistic regression was used to explore the association between periodontal status and low cognitive performance, with analyses stratified by race/ethnicity. RESULTS: The prevalence of cognitive impairment increased with greater periodontal disease severity. Participants with severe periodontitis had the highest prevalence of impairment in DSST (28%), AFT (21%), and CERAD-IR (23%). Logistic regression analysis showed that severe periodontitis was significantly associated with low DSST scores overall (OR=2.3, 95% CI: 1.4–4.0, p=0.01), with the strongest association observed among Hispanic participants (OR=2.6, 95% CI: 1.1–6.1, p=0.0342). A significant interaction by race/ethnicity was observed for AFT (p=0.0273), where an unexpected inverse association was found in the “Other” race group (OR=0.4, 95% CI: 0.1–0.9, p=0.0074). CONCLUSIONS: The study indicates that the link between periodontitis and cognitive impairment differs by racial/ethnic group, with a notably stronger association among Hispanic individuals and a possible inverse relationship in the "Other" group, potentially due to random error or unmeasured factors. These findings highlight the importance of inclusive research and cautious interpretation of subgroup data. Periodontitis may be a modifiable risk factor for cognitive decline, with effects varying by race, emphasizing the need for future longitudinal and interventional studies to assess causality and treatment impact across diverse populations.en-USDentistryPublic healthHealth sciencesThesis/Dissertation2025-07-220009-0006-9146-2893