Large study links gum disease with dementia


The mouth is home to approximately 700 species of bacteria, including those that cause periodontal (gum) disease. A recent analysis led by NIA scientists suggests that the bacteria that cause gum disease are also linked to the development of Alzheimer's disease and related dementias, particularly vascular dementia.Results are reported in Journal of Alzheimer's Disease.

Close-up of an elderly man with a sunken lower part of his face and a sunken mouthGum disease is caused by an infection of the oral tissues that hold your teeth in place. Bleeding gums, loose teeth, and even tooth loss are the main effects of this disease. Bacteria and the inflammatory molecules they produce can travel from oral infections to the brain via the bloodstream. Previous laboratory studies have suggested that this is a mechanism that affects the chain of events that lead to dementia, but large-scale human studies have not yet been conducted to confirm this relationship.

The NIA Intramural Research Program team used publicly available, nationally representative data from the National Health and Nutrition Examination Survey (NHANES), a large population-based study conducted by the CDC's National Center for Health Statistics. The research team examined whether gum disease and oral bacterial infections are associated with dementia diagnoses and death, using limited data linkage with Medicare records and the National Death Index. The team compared baseline across age groups and followed more than 6,000 participants for 26 years.

NHANES participants received dental exams to check for signs of gum disease. In addition, participants received blood tests for antibodies against disease-causing bacteria. The team analyzed antibodies against 19 species of oral bacteria to determine associations with a diagnosis of Alzheimer's disease, a diagnosis of any type of dementia, and death from Alzheimer's disease. Among these 19, Porphyromonas gingivalis It is the most common culprit of gum disease. In fact, a recent study suggests that beta-amyloid plaques, a major hallmark of Alzheimer's disease, may develop in response to this infection.

The analysis showed that older adults with signs of gum disease and oral infections at baseline were more likely to develop Alzheimer's disease during the study period.Alzheimer's diagnosis and death linked to oral bacteria antibodies in people 65 or older Porphyromonas gingivalis, It can aggregate with other bacteria, e.g. Campylobacter rectum and Prevotella melanogaster further increasing these risks.

This study requires long-term follow-up because the findings suggest that oral infection precedes the diagnosis of dementia. After all, having dementia makes a person more likely to be unable to brush and floss effectively, increasing the likelihood of infection and gum disease. Regardless, it is important to remember that population studies can show association, but not causation.The authors stress the need for clinical trials to test whether the infection can be treated with drugs Porphyromonas gingivalis May reduce the development or symptoms of dementia.

This research was fully supported by the NIA Intramural Research Program.

refer to: Beydoun M et al. A large national survey reveals clinical and bacterial markers of periodontitis and its association with all-cause dementia and Alzheimer's disease dementia. Journal of Alzheimer's Disease. 2020;75(1):157-172. Two: 10.3233/JAD-200064.



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