Abstract P042: Association between Allostatic Load and Periodontal Disease in a Cohort of Older Danish Adults: A Longitudinal Perspective
While recent cross-sectional studies suggest an association between allostatic load and chronic infection-induced inflammation such as periodontal disease, longitudinal studies are needed to better understand the nature of this relationship. Using prospective data from the 1914 Glostrup Aging Study with 15 years of follow-up, we examined the relationship between allostatic load and periodontal disease in a birth cohort of 453 older adults residing in Glostrup, Denmark. Periodontal disease was assessed using a modified version of the Community Periodontal Index at age 70 and with measures of periodontal pocket depths (PD) and clinical attachment loss (CAL) at age 85. Summary measures of allostatic load were constructed using a count-based formulation incorporating inflammatory, metabolic and anthropometric markers at ages 70 and 80. Structured questionnaires were administered at each follow-up assessment to ascertain social and behavioral characteristics. We constructed proportional-odds and linear regression models to evaluate associations of allostatic load at ages 70 and 80 with periodontal inflammation cross-sectionally at age 70 and prospectively at age 85. Overall, allostatic load at age 70 was positively associated with higher levels of periodontal inflammation cross-sectionally, controlling for sex, smoking, and physical activity (adjusted odds ratio: 1.85 comparing quartiles 2 - 4 vs. 1, 95% confidence interval: 1.01 - 3.42). Prospectively, positive associations were observed for allostatic load at age 70 with percentage of tooth sites with PD ≥ 3 mm (beta coefficient: 17.1 comparing quartile 4 vs. 1-3, P-value=0.02) and PD ≥ 3 mm (beta coefficient: 14.1 comparing quartile 4 vs. 1-3, P-value=0.04) in multivariable models. Similar but non-significant patterns of associations were observed between allostatic load at age 70 and CAL at age 85. Our results demonstrate that physiological dysregulation in early old age may influence the course of periodontal disease, and these findings support emerging evidence that suggests a role of chronic stress on inflammation.
- © 2013 by American Heart Association, Inc.