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 “What we have shown is that regardless of the severity of dementia
(within this mild to moderate impaired group) that patients with
more severe gum disease are declining more rapidly,” said senior
author Clive Holmes of the University of Southampton in the UK.
In other studies, Holmes and his coauthors have found that
conditions such as chest infections, urinary tract infections,
rheumatoid arthritis and diabetes are associated with faster disease
progression in Alzheimer’s, he said.
“We hadn’t previously looked at gum disease because MDs tend to
leave this in the hands of dentists but it is an important common
low grade chronic infection,” Holmes told Reuters Health by email.
The researchers observed 60 people with mild to moderate Alzheimer’s
disease living at home for six months. The participants did not
smoke, had not been treated for gum disease within the previous six
months, and had at least 10 teeth.
At the start, each participant completed a cognitive assessment,
gave a blood sample, was examined by a dental hygienist and their
main caregiver was interviewed to provide a medical and dental
history. The same tests and interviews were repeated six months
later.
Of the 60 people in the study, 22 had moderate to severe gum disease
at the beginning of the study. By six months later, one participant
had died, three had withdrawn from the study and three were lost to
follow-up.
Cognitive score declined more for those who had periodontitis to
begin with than for those who did not, as reported in PLoS One.
According to one theory, cognitive impairment leads to adverse oral
health due to inattention to routine oral hygiene and care, said Dr.
James M. Noble of the Taub Institute for Research on Alzheimer’s
Disease and the Aging Brain at Columbia University Medical Center in
New York City, who was not part of the new study.
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“The second, and the one I’m most intrigued by, is whether or not
periodontal disease has an influence on cognitive outcomes of aging,
either as an independent risk factor for (new-onset) cognitive
impairment including Alzheimer disease, or more rapid decline once
(Alzheimer’s disease) has been diagnosed, as was suggested by this
study,” Noble told Reuters Health by email.
Gum disease may cause chronic low-grade inflammation in the rest of
the body, and inflammation is associated with changes in the brain,
he said.
“It is known that gum disease is associated with increased markers
of inflammation,” Holmes said.
But the new study indicates a connection between gum disease and
cognitive decline, not necessarily that one causes the other, he
said. Further studies need to assess whether treating the gum
disease would also slow cognitive decline.
“Periodontitis has been associated with heart disease and stroke
among other conditions,” Noble said.
Based on this and other studies, “it seems to be good advice to
brush and floss,” Noble said.
SOURCE: http://bit.ly/22aCm6p PLoS One, online February 24, 2016.
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