16 Mar 16

Clinical Essentials from PLoS One  curated by Laurie Barclay, MD

Takeaway

• Cognitive decline in early Alzheimer’s disease (AD) is linked to periodontitis, independent of baseline cognition.

Study design

• 60 community residents (mean 77.7±8.6 years; 51% men) with mild/moderate AD underwent cognitive, dental, and blood testing at baseline and at 6 months (n=52).

Key results

• Baseline periodontitis (in 37.3%), diagnosed by a dental hygienist blinded to cognitive outcomes, was associated with a sixfold increase in rate of cognitive decline on the ADAS-cog and with increase in blood pro-inflammatory markers over 6 months, but not with baseline ADAS-cog.

Limitations

• Small sample; limited follow-up duration.

Why this matters

• Elevated antibodies to periodontal bacteria have been associated with increased systemic pro-inflammatory state, and elevated serum pro-inflammatory cytokines have been associated with increased cognitive decline in AD.
• Increased cognitive decline with periodontitis may be mediated through systemic inflammation, suggesting potential therapeutic interventions.
• If the findings are confirmed in larger studies, treatment of periodontitis may help prevent decline in AD.

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