Periodontitis and cognitive decline in Alzheimer's disease.
Perry, V. Hugh
- Publisher: Public Library of Science
(issn: 1932-6203, eissn: 1932-6203)
Digestive System | /dk/atira/pure/core/subjects/dentistry | Research Article | Anatomy | Dentistry | Signs and Symptoms | Pathology and Laboratory Medicine | Inflammatory Diseases | Mental Health and Psychiatry | Head | Neurodegenerative Diseases | Molecular Development | Immune Response | Inflammation | Immune System | Teeth | Cytokines | Periodontal Diseases | Immunology | Neurology | RC0321 | Oral Medicine | Alzheimer Disease | Jaw | Biology and Life Sciences | Immune Physiology | Neuroscience | Developmental Biology | Physiology | Medicine | Innate Immune System | Q | R | Oral Diseases | Cognitive Neurology | Science | Periodontitis | Dementia | Cognitive Impairment | Medicine and Health Sciences | Cognitive Neuroscience | Cognitive Science
Background. Periodontitis is common in the elderly and may become more common in Alzheimer’s disease because of a reduced ability to take care of oral hygiene as the disease progresses. Elevated antibodies to periodontal bacteria are associated with an increased systemic pro-inflammatory state. Elsewhere raised serum pro-inflammatory cytokines have been associated with an increased rate of cognitive decline in Alzheimer’s disease. We hypothesized that periodontitis would be associated with increased dementia severity and a more rapid cognitive decline in Alzheimer’s disease.<br/>Objectives. To determine if periodontitis in Alzheimer’s disease is associated with both increased dementia severity and cognitive decline, and an increased systemic pro inflammatory state. <br/>Methods. In a six month observational cohort study 60 community dwelling participants with mild to moderate Alzheimer’s Disease were cognitively assessed and a blood sample taken for systemic inflammatory markers. Dental health was assessed by a dental hygienist, blind to cognitive outcomes. All assessments were repeated at six months. <br/>Results. The presence of periodontitis at baseline was not related to baseline cognitive state but was associated with a six fold increase in the rate of cognitive decline as assessed by the ADAS-cog over a six month follow up period. Periodontitis at baseline was associated with a relative increase in the pro-inflammatory state over the six month follow up period. <br/>Conclusions. Periodontitis is associated with an increase in cognitive decline in Alzheimer’s Disease, independent to baseline cognitive state, which may be mediated through effects on systemic inflammation. <br/>Funding. Dunhill Medical Trust [grant number R190/0211].