Association of Alzheimer’s disease and periodontitis - a systematic review and meta-analysis of evidence from observational studies

Kaliamoorthy, Sriram; Nagarajan, Mahendirakumar; Sethuraman, Vijayparthiban; Jayavel, Kavitha; Lakshmanan, Vijayalakshmi; Palla, Santosh

doi:10.15386/mpr-2278

Cited by 16 publications

(20 citation statements)

References 48 publications

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“…As cognitive decline may also lead to poor periodontal health, reverse causality may confound the association. 39 , 40 To account for this, only longitudinal studies were included. 41 For dementia as an outcome, studies were restricted to dementia‐free participants at baseline, and an additional meta‐analysis was conducted restricting each main model (Figure 3A–E ) to studies with ≥10 years of follow‐up (Figure S4 A–E).…”

Section: Methodsmentioning

confidence: 99%

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Asher

Stephen

Mäntylä

et al. 2022

J American Geriatrics Society

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Background Emerging evidence indicates that poor periodontal health adversely impacts cognition. This review examined the available longitudinal evidence concerning the effect of poor periodontal health on cognitive decline and dementia. Methods Comprehensive literature search was conducted on five electronic databases for relevant studies published until April 2022. Longitudinal studies having periodontal health as exposure and cognitive decline and/or dementia as outcomes were considered. Random effects pooled estimates and 95% confidence intervals were generated (pooled odds ratio for cognitive decline and hazards ratio for dementia) to assess whether poor periodontal health increases the risk of cognitive decline and dementia. Heterogeneity between studies was estimated by I2 and the quality of available evidence was assessed through quality assessment criteria. Results Adopted search strategy produced 2132 studies for cognitive decline and 2023 for dementia, from which 47 studies (24 for cognitive decline and 23 for dementia) were included in this review. Poor periodontal health (reflected by having periodontitis, tooth loss, deep periodontal pockets, or alveolar bone loss) was associated with both cognitive decline (OR = 1.23; 1.05–1.44) and dementia (HR = 1.21; 1.07–1.38). Further analysis, based on measures of periodontal assessment, found tooth loss to independently increase the risk of both cognitive decline (OR = 1.23; 1.09–1.39) and dementia (HR = 1.13; 1.04–1.23). Stratified analysis based on the extent of tooth loss indicated partial tooth loss to be important for cognitive decline (OR = 1.50; 1.02–2.23) and complete tooth loss for dementia (HR = 1.23; 1.05–1.45). However, the overall quality of evidence was low, and associations were at least partly due to reverse causality. Conclusions Poor periodontal health and tooth loss appear to increase the risk of both cognitive decline and dementia. However, the available evidence is limited (e.g., highly heterogenous, lacking robust methodology) to draw firm conclusions. Further well‐designed studies involving standardized periodontal and cognitive health assessment and addressing reverse causality are highly warranted.

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Section: Methodsmentioning

confidence: 99%

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Asher

Stephen

Mäntylä

et al. 2022

J American Geriatrics Society

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“…There is rising evidence for an association between intraoral inflammatory conditions and AD [ 17 , 18 , 19 ]. More than 50% of all people over the age of 35 worldwide are affected by periodontitis, and approximately 10–15% suffer from a severe form of the disease which can lead to the loss of dentition [ 333 ].…”

Section: Individual Approachesmentioning

confidence: 99%

“…Such a relationship is also discussed for dementia, especially AD, and the intraoral condition, which may be bidirectional: on the one hand, the reduction in memory capacity caused by AD is certainly causal for the decrease in personal oral hygiene ability and thus ultimately for the increase in the risk for the development of caries and periodontitis [ 341 , 342 ]. On the other hand, there is evidence that periodontitis itself and the associated microbial colonization and inflammatory response is associated with AD [ 18 , 19 , 343 , 344 ].…”

Section: Individual Approachesmentioning

confidence: 99%

“…Frequent physical activity, promotion of communication to maintain social interactions, and a healthy diet to avoid the risks of obesity and diabetes may therefore affect neuropathological damage and cognitive reserve [ 16 ] and contribute to the prevention or delay of dementia. According to current literature, the intraoral condition could also represent such a modifiable risk factor [ 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Ablinger¹,

Dressel

Rott³

et al. 2022

Biomedicines

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Alzheimer’s disease is one of the most common neurodegenerative diseases in the western population. The incidence of this disease increases with age. Rising life expectancy and the resulting increase in the ratio of elderly in the population are likely to exacerbate socioeconomic problems. Alzheimer’s disease is a multifactorial disease. In addition to amyloidogenic processing leading to plaques, and tau pathology, but also other molecular causes such as oxidative stress or inflammation play a crucial role. We summarize the molecular mechanisms leading to Alzheimer’s disease and which potential interventions are known to interfere with these mechanisms, focusing on nutritional approaches and physical activity but also the beneficial effects of cognition-oriented treatments with a focus on language and communication. Interestingly, recent findings also suggest a causal link between oral conditions, such as periodontitis or edentulism, and Alzheimer’s disease, raising the question of whether dental intervention in Alzheimer’s patients can be beneficial as well. Unfortunately, all previous single-domain interventions have been shown to have limited benefit to patients. However, the latest studies indicate that combining these efforts into multidomain approaches may have increased preventive or therapeutic potential. Therefore, as another emphasis in this review, we provide an overview of current literature dealing with studies combining the above-mentioned approaches and discuss potential advantages compared to monotherapies. Considering current literature and intervention options, we also propose a multidomain interdisciplinary approach for the treatment of Alzheimer’s disease patients that synergistically links the individual approaches. In conclusion, this review highlights the need to combine different approaches in an interdisciplinary manner, to address the future challenges of Alzheimer’s disease.

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“…In recent studies(Holmer, Eriksdotter, Schultzberg, Pussinen, & Buhlin, 2018), periodontitis has been shown to be an important risk factor for Alzheimer's disease. The results of cross-sectional and longitudinal studies have shown (Fu et al, 2022;Kaliamoorthy et al, 2022), periodontitis is strongly associated with cognitive impairment (CI) and Alzheimer's disease (AD). In addition, studies on AD patients from patients with periodontitis and human animal models have shown (Ilievski et al, 2018), Porphyromonas gingivalis (Pg) and/or its product gingival protease were transferred to the brain.…”

Section: Introductionmentioning

confidence: 99%

Key genes associated with Alzheimer's disease and periodontitis

Zhou

Wang

et al. 2022

Preprint

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Background: With increasing research on Alzheimer's disease and periodontitis, many studies suggest a close correlation between Alzheimer's disease and periodontitis, but the underlying pathophysiological mechanisms remain unclear. The aim of this study was to identify potential pivotal genes and pathways associated with both diseases by using a bioinformatics approach. Materials/Methods: The GEO dataset GSE5281 for Alzheimer's disease patients and normal controls was downloaded from the GEO database. The GSE10334 dataset for periodontitis patients and healthy controls was also obtained. Differentially expressed genes (DEGs) for the Alzheimer's disease and periodontitis datasets were obtained, as well as genes common between them. Further GO and KEGG enrichment analyses were performed on the common genes. To determine the pathogenesis associated with Alzheimer's disease and periodontitis, protein-protein interaction (PPI) networks were constructed. Finally, the diagnostic value of HUB genes in the Alzheimer's disease and periodontitis datasets was analyzed separately using SPSS software. Results: A total of 16 common genes were obtained for Alzheimer's disease and periodontitis with a P value <0.05. 7 GO entries and 2 KEGG pathways were obtained. In addition, the first 6 central genes (CD4, KDR, CXCR4, CXCL12, JAK2 and PTPN11) were selected with a P<0.05. Conclusion: The results of this study suggest that some novel genes play an important role in the development and progression of Alzheimer's disease and periodontitis. More experimental studies and clinical trials are needed to validate our results.

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Association of Alzheimer’s disease and periodontitis - a systematic review and meta-analysis of evidence from observational studies

Cited by 16 publications

References 48 publications

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Periodontal health, cognitive decline, and dementia: A systematic review and meta‐analysis of longitudinal studies

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Key genes associated with Alzheimer's disease and periodontitis

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