{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T18:35:48Z","timestamp":1769106948605,"version":"3.49.0"},"reference-count":63,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2021,3,12]],"date-time":"2021-03-12T00:00:00Z","timestamp":1615507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Patients suffering from periodontitis are at a higher risk of developing cognitive dysfunction. However, the mediation effect of an inflammatory diet and serum vitamin D levels in this link is unclear. In total, 2062 participants aged 60 years or older with complete periodontal diagnosis and cognitive tests from the National Health and Nutrition Examination Survey (NHANES) 2011\u20132012 and 2013\u20132014 were enrolled. The Consortium to Establish a Registry for Alzheimer\u2019s disease (CERAD) word learning subtest (WLT) and CERAD delayed recall test (DRT), the animal fluency test (AFT) and the digit symbol substitution test (DSST) was used. Dietary inflammatory index (DII) was computed via nutrition datasets. Mediation analysis tested the effects of DII and vitamin D levels in the association of mean probing depth (PD) and attachment loss (AL) in all four cognitive tests. Periodontitis patients obtained worse cognitive test scores than periodontally healthy individuals. DII was negatively associated with CERAD-WLT, CERAD-DRT, AFT and DSST, and was estimated to mediate between 9.2% and 36.4% of the total association between periodontitis with cognitive dysfunction (p &lt; 0.05). Vitamin D showed a weak association between CERAD-DRT, AFT and DSST and was estimated to between 8.1% and 73.2% of the association between periodontitis and cognitive dysfunction (p &lt; 0.05). The association between periodontitis and impaired cognitive function seems to be mediated both by a proinflammatory dietary load and vitamin D deficiency. Future studies should further explore these mediators in the periodontitis-cognitive decline link.<\/jats:p>","DOI":"10.3390\/nu13030924","type":"journal-article","created":{"date-parts":[[2021,3,14]],"date-time":"2021-03-14T23:52:06Z","timestamp":1615765926000},"page":"924","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["The Role of Inflammatory Diet and Vitamin D on the Link between Periodontitis and Cognitive Function: A Mediation Analysis in Older Adults"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-8263","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Botelho","sequence":"first","affiliation":[{"name":"Periodontology Department, Instituto Universit\u00e1rio Egas Moniz, 2829-511 Almada, Portugal"},{"name":"Evidence-Based Hub, Clinical Research Unit, Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal"}]},{"given":"Yago","family":"Leira","sequence":"additional","affiliation":[{"name":"Periodontology Unit, UCL Eastman Dental Institute and NIHR UCLH Biomedical Research Centre, University College London, London WC1E 6DE, UK"},{"name":"Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain"},{"name":"Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"},{"name":"Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"}]},{"given":"Jo\u00e3o","family":"Viana","sequence":"additional","affiliation":[{"name":"Evidence-Based Hub, Clinical Research Unit, Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-260X","authenticated-orcid":false,"given":"Vanessa","family":"Machado","sequence":"additional","affiliation":[{"name":"Periodontology Department, Instituto Universit\u00e1rio Egas Moniz, 2829-511 Almada, Portugal"},{"name":"Evidence-Based Hub, Clinical Research Unit, Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal"}]},{"given":"Patr\u00edcia","family":"Lyra","sequence":"additional","affiliation":[{"name":"Evidence-Based Hub, Clinical Research Unit, Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal"}]},{"given":"Jos\u00e9 Manuel","family":"Aldrey","sequence":"additional","affiliation":[{"name":"Dementia Unit, Department of Neurology, Clinical University Hospital, 15706 Santiago de Compostela, Spain"}]},{"given":"Juan Manuel","family":"P\u00edas-Peleteiro","sequence":"additional","affiliation":[{"name":"Dementia Unit, Department of Neurology, Clinical University Hospital, 15706 Santiago de Compostela, Spain"}]},{"given":"Juan","family":"Blanco","sequence":"additional","affiliation":[{"name":"Periodontology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, 15706 Santiago de Compostela, Spain"},{"name":"Medical-Surgical Dentistry (OMEQUI) Research Group, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9760-8690","authenticated-orcid":false,"given":"Tom\u00e1s","family":"Sobrino","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences Research Laboratory, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0167-4077","authenticated-orcid":false,"given":"Jos\u00e9 Jo\u00e3o","family":"Mendes","sequence":"additional","affiliation":[{"name":"Evidence-Based Hub, Clinical Research Unit, Centro de Investiga\u00e7\u00e3o Interdisciplinar Egas Moniz, 2829-511 Almada, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,12]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2020, October 19). 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