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

Periodontal disease severity in subjects with dementia: A systematic review and meta-analysis

Archives of gerontology and geriatrics

Despite clinical trials and reviews attempt to assess a possible relationship between dementia and periodontal disease, no meta-analysis has been performed and this issue remains undetermined. The aim of this study is to conduct a systematic review and meta-analysis to assess severity of periodontitis in subjects with dementia. The search was conducted in Pubmed, Embase/MEDLINE. Two independent reviewers extracted data and assessed the risk bias (Newcastle-Ottawa scale). Meta-analyses were performed using the means of probing depth (PD) and clinical attachment loss (CAL) in patients with or without dementia. The mean difference were analyzed (P ≤ 0.05). Fourteen studies were included in the systematic review. In the qualitative analysis, most studies reported higher prevalence of periodontal disease in dementia patients. The studies had low risk of bias and two meta-analyses were performed for each parameter, including or not a cross-sectional study. The meta-analyses including the ...

Clinical periodontal variables in patients with and without dementia-a systematic review and meta-analysis

Clinical oral investigations, 2018

Considering the increasing number of elderly people, dementia has gained an important role in today's society. Although the contributing factors for dementia have not been fully understood, chronic periodontitis (CP) seems to have a possible link to dementia. To conduct a systematic review including meta-analysis in order to assess potential differences in clinical periodontal variables between patients with dementia and non-demented individuals. The following focused question was evaluated: is periodontitis associated with dementia? Electronic searches in two databases, MEDLINE and EMBASE, were conducted. Meta-analysis was performed with the collected data in order to find a statistically significant difference in clinical periodontal variables between the group of dementia and the cognitive normal controls. Forty-two articles remained for full text reading. Finally, seven articles met the inclusion criteria and only five studies provided data suitable for meta-analysis. Period...

Association between periodontitis and Alzheimer′s disease: Does the link exist?

Indian Journal of Oral Sciences, 2016

Purpose To test the hypothesis that periodontitis is associated with AD and search whether periodontal and other variables would negatively impact the oral health-related quality of life (OHRQoL) perception. Materials and methods Oral examinations and interview on self-perceived oral health status (Geriatric Oral Health Assessment Index (GOHAI) questionnaire (higher score corresponds to better perceived oral status)) were carried out and socio-demographic data were collected from outpatients with mild to moderate AD (cases, n = 50) and from their age-and sex-matched family caregivers (controls, n = 52). Full-mouth periodontal examination was performed. Significance of differences between groups was sought by chi-square, Student's t, or the Mann-Whitney test. The association between the variables periodontitis, probing depth (PD) ≥ 5 mm, and clinical attachment loss (CAL) ≥ 5 mm with the variable group was tested in binary logistic regression models (LRMs). LRMs were used to test the association of oral findings, demographics, and group with GOHAI. Results Cases had fewer teeth and greater CAL than controls. Cases had a superior percentage of sites with plaque, calculus, and bleeding on probing than controls. Cases had greater GOHAI scores than controls. Periodontitis was a variable most likely associated with AD (OR = 11.08, p < 0.001). None of the oral findings or demographics, but group, was associated with GOHAI (OR = 14.45, p < 0.001). Conclusion Periodontitis is associated with AD, but not with patients' OHRQoL. Clinical relevance Health care professionals must be aware that AD patients should have a periodic thorough oral examination and preventive intervention aiming at their welfare and maintenance of a pain-free functional dentition.

Periodontal status in patients with Alzheimer’s disease: a scoping review

Majalah Kedokteran Gigi Indonesia

Periodontitis is the most common condition of chronic periodontal infection and inflammation in the elderly population. Periodontal disease can cause local inflammation that contributes to higher risk of systemic inflammatory disease. Current research suggests a possible link between periodontal disease and neurodegenerative disease, such as Alzheimer’s disease. The aim of the study is to provide a profile of the periodontal tissue status in people with Alzheimer’s disease. This scoping review followed Joanna Briggs Institute (JBI) guideline, and the searching was conducted using PubMed, Cochrane, and EBSCOHost databases during February 6th – February 7th, 2021 with keywords of periodontal disease, periodontitis, periodontal inflammation, Alzheimer’s disease and dementia. It also included MeSH terms of “periodontal disease” and “Alzheimer’s disease” if available. Additionally, snowballing technique was used to include more articles. The identification and writing process for this ar...

Association between chronic periodontitis and the risk of Alzheimer’s disease: a retrospective, population-based, matched-cohort study

Alzheimer's Research & Therapy

Background: Although recent short-term cross-sectional studies have revealed that chronic periodontitis (CP) may be a risk factor for increased cognitive impairment in patients with Alzheimer's disease (AD), systematic reviews and long-term longitudinal studies have provided less clear evidence regarding the relationship between CP and AD. Therefore, we conducted a retrospective cohort study using the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients with CP are at increased risk of developing AD. Methods: We conducted a retrospective matched-cohort study using the NHIRD of Taiwan. We identified 9291 patients newly diagnosed with CP between 1997 and 2004. A total of 18,672 patients without CP were matched to the patient cohort according to sex, age, index year, co-morbidity and urbanisation level. Cox proportional hazards regression analyses were performed to evaluate the subsequent risk of AD. Results: Patients with CP had a higher prevalence of hyperlipidaemia, depression, traumatic brain injury and co-morbidities, as well as higher urbanisation levels, than those in the unexposed cohort (all p < 0.01). At the final follow-up, totals of 115 (1.24%) and 208 (1.11%) individuals in the CP exposed and unexposed groups, respectively, had developed AD. Patients with 10 years of CP exposure exhibited a higher risk of developing AD than unexposed groups (adjusted HR 1.707, 95% CI 1.152-2.528, p = 0.0077). Conclusions: Our findings demonstrate that 10-year CP exposure was associated with a 1.707-fold increase in the risk of developing AD. These findings highlight the need to prevent progression of periodontal disease and promote healthcare service at the national level.

Relationship Between Alzheimer's Disease and Periodontal Disease-A Brief Review

2015

Alzheimer’s disease (AD) is the most common cause of dementia in the elderly age group and a major health problem in the geriatric subjects worldwide. It is a chronic neurodegenerative disease that usually starts slowly and gets worse over time. Alzheimer’s disease is marked by salient inflammatory features, characterized by microglial activation and escalation in the levels of pro-inflammatory cytokines in the affected regions. Periodontal infections may result in harmful pathogenic products leading to systemic inflammatory responses. Elevated systemic inflammatory response may contribute to the exacerbation of existing brain pathologies. Infections may also contribute to vascular pathology with the potential to impact brain function. This review elucidates the possible role of periodontitis in exacerbating Alzheimer’s disease. Periodontitis shares the two important features of Alzheimer’s disease namely oxidative damage and inflammation, which are exhibited in the brain pathology ...

Periodontitis and Alzheimer’s disease: oral systemic link still on the rise?

Gerodontology, 2013

Periodontitis and Alzheimer's disease: Oral systemic link still on the rise? Over the past few years, there has been a rapid rise in the older segments of the world population, which has brought along with it a major health concern: dementia. Alzheimer's disease, considered to be the most common cause of dementia, has become a prospect feared by the elderly. Inflammation of the brain is strongly implicated in Alzheimer's disease which could be enhanced by systemic inflammation. Periodontitis being a chronic inflammatory condition, which can cause systemic inflammation, the question is whether chronic periodontitis can initiate or hasten the rate of progression of Alzheimer's disease in susceptible individuals. In this article, the authors outline the proposed oral systemic link between periodontitis and Alzheimer's disease.