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Periodontal health was assessed via multiple clinical and radiographic markers. Based on periodontal pocket depths (PPDs), we defined periodontitis as moderate or severe. Cognitive tests at baseline and follow\u2010up were administered, and dementia diagnoses until 2015 were retrieved from health registers. Analyses included logistic and Cox proportional regression, accounting for reverse causality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cross\u2010sectionally, moderate periodontitis was associated with lower overall cognition (OR\u2009=\u20091.19:1.02\u20131.40), verbal fluency (OR\u2009=\u20091.16:1.00\u20131.35) and immediate recall (OR\u2009=\u20091.22:1.04\u20131.42); PPD with lower overall cognition (OR\u2009=\u20091.22:1.04\u20131.43) and verbal fluency (OR\u2009=\u20091.18:1.02\u20131.38); and bleeding on probing (BOP) with verbal fluency (OR\u2009=\u20091.26:1.07\u20131.48) and immediate recall (OR\u2009=\u20091.22:1.02\u20131.45). Longitudinally, moderate periodontitis was associated with the risk of decline in immediate recall (OR\u2009=\u20091.29:1.04\u20131.60) and severe periodontitis with verbal fluency (OR\u2009=\u20091.46:1.01\u20132.11); PPD with immediate recall (OR\u2009=\u20091.23:1.00\u20131.53); and BOP with verbal fluency (OR\u2009=\u20091.31:1.05\u20131.63). Edentulism was associated with multiple cognitive tests (OR range:1.71\u20131.88). No associations with the risk of incident dementia were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Poor periodontal health may increase the risk of cognitive decline. Future studies into the underlying mechanisms are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jcpe.14173","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T21:28:48Z","timestamp":1747344528000},"page":"1082-1098","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Clinical and Radiological Markers of Periodontal Status and Risk of Cognitive Decline and Incident Dementia"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3093-4720","authenticated-orcid":false,"given":"Sam","family":"Asher","sequence":"first","affiliation":[{"name":"Institute of Dentistry University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-0055","authenticated-orcid":false,"given":"Anna 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