title: Possible relationship between periodontitis and dementia in a North Indian old age population: a pilot study.
abstract: BACKGROUND
  Periodontitis and cognitive impairment or dementia is relatively common among older adults. Few cross-sectional studies and some longitudinal studies have attempted to link oral health with dementia diagnosis or disease pathology but none has investigated the role of inflammation as a potential mediator.
  
  
  OBJECTIVE
  This study was planned to establish a relation of inflammatory mediators between periodontitis and dementia.
  
  
  METHODS
  Fifty-five patients with severe periodontitis (range 60-69 years), 20 with dementia (10:10 M:F; range 59-69) and 32 healthy controls (range 58-69 years) were selected. The socio-demographic characteristics, physical health, oral health, education status, and medical status were measured. Serum C-reactive protein (CRP), matrix metalloproteinase (MMP)-8, MMP-9, total IGF-I, free IGF-I and TNF-alpha and GCF MMP-8 &MMP-9 were calculated.
  
  
  RESULTS
  There was no significant difference between the three groups in the level of education, age, occupation, BMI, CAD, CHF and diabetes except dentate status. After adjusting for age, significant differences were found between patients and controls with respect to gingival inflammation, dental plaque, bleeding on probing and probing pocket depth. Total counts of WBCs, neutrophils, thrombocytic counts and serum CRP, MMP-8, MMP-9, TNF-alpha levels were significantly higher in dementia and periodontitis patients in contrast to healthy controls, while, RBC counts, total IGF-I and Hb levels were lowered in dementia and periodontitis patients in comparison to healthy controls, although higher in dementia as compared to periodontitis patients.
  
  
  CONCLUSIONS
  This study data suggest a relationship of inflammatory mediators between periodontitis and dementia. Further exploration of this is warranted.
authors.affiliation: Oral Imaging Center, School of Dentistry, Oral Pathology and Maxillofacial Surgery, Katholieke Universiteit Leuven, Leuven, Belgium. drbalwantraissct@rediffmail.com
authors.forename: Balwant
authors.initials: B
authors.lastname: Rai
authors.forename: Jasdeep
authors.initials: J
authors.lastname: Kaur
authors.forename: S C
authors.initials: SC
authors.lastname: Anand
mesh_terms: D000368:Aged; D001772:Blood Cell Count; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002908:Chronic Disease; D003704:Dementia / Q000150:complications* / Q000276:immunology; D003773:Dental Plaque / Q000150:complications; D004522:Educational Status; D005260:Female; D005883:Gingival Crevicular Fluid / Q000201:enzymology; D005884:Gingival Hemorrhage / Q000150:complications; D005891:Gingivitis / Q000150:complications; D006304:Health Status; D006801:Humans; D007194:India; D018836:Inflammation Mediators / Q000032:analysis*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D020784:Matrix Metalloproteinase 8 / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D009909:Oral Health; D010514:Periodontal Pocket / Q000150:complications; D010518:Periodontitis / Q000150:complications* / Q000276:immunology; D010865:Pilot Projects; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D018836:Inflammation Mediators; D014409:Tumor Necrosis Factor-alpha; D007334:Insulin-Like Growth Factor I; D002097:C-Reactive Protein; C488762:MMP8 protein, human; D020784:Matrix Metalloproteinase 8; D020780:Matrix Metalloproteinase 9