title: Periodontitis and Cognitive Decline in Alzheimer's Disease.
abstract: 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. We aimed 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. 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. 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. Our data showed that 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.
authors.affiliation: Dental Institute, Kings College London, Guy's Hospital, London, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Ide
authors.affiliation: University of Southampton, Faculty of Medicine, Clinical Experimental Science, Southampton, United Kingdom.
authors.forename: Marina
authors.initials: M
authors.lastname: Harris
authors.affiliation: Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, United Kingdom.
authors.forename: Annette
authors.initials: A
authors.lastname: Stevens
authors.affiliation: University of Southampton, Faculty of Medicine, Clinical Experimental Science, Southampton, United Kingdom.|Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, United Kingdom.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sussams
authors.affiliation: Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, United Kingdom.
authors.forename: Viv
authors.initials: V
authors.lastname: Hopkins
authors.affiliation: University of Southampton, Faculty of Health Sciences, NIHR CLAHRC Wessex Methodological Hub, Southampton, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Culliford
authors.affiliation: University of Southampton, Faculty of Natural and Environmental Science, Centre for Biological Sciences, Southampton, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Fuller
authors.affiliation: University of Southampton, Faculty of Natural and Environmental Science, Centre for Biological Sciences, Southampton, United Kingdom.
authors.forename: Paul
authors.initials: P
authors.lastname: Ibbett
authors.affiliation: Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Raybould
authors.affiliation: Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom.
authors.forename: Rhodri
authors.initials: R
authors.lastname: Thomas
authors.affiliation: University of Southampton, Faculty of Natural and Environmental Science, Centre for Biological Sciences, Southampton, United Kingdom.
authors.forename: Ursula
authors.initials: U
authors.lastname: Puenter
authors.affiliation: University of Southampton, Faculty of Natural and Environmental Science, Centre for Biological Sciences, Southampton, United Kingdom.
authors.forename: Jessica
authors.initials: J
authors.lastname: Teeling
authors.affiliation: University of Southampton, Faculty of Natural and Environmental Science, Centre for Biological Sciences, Southampton, United Kingdom.
authors.forename: V Hugh
authors.initials: VH
authors.lastname: Perry
authors.affiliation: University of Southampton, Faculty of Medicine, Clinical Experimental Science, Southampton, United Kingdom.|Memory Assessment and Research Centre, Moorgreen Hospital, Southampton, United Kingdom.
authors.forename: Clive
authors.initials: C
authors.lastname: Holmes
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D003072:Cognition Disorders / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010518:Periodontitis / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D013997:Time Factors