A new study published in the journal PLOS One suggests there is a link between gum disease and greater
rates of cognitive decline in people with early stages of Alzheimer's disease.
Periodontitis or gum disease is an unpleasant condition,
causing bad breath, bleeding and painful gums, ulcers and even tooth loss.
The disease is more common in women than men. Persistent bad
breath and red, swollen or bleeding gums are common signs of the condition.
Poor oral hygiene, smoking and diabetes are all risk factors for gum disease.
The disease is common in older people and may become more
common in Alzheimer's disease because of a reduced ability to take care of oral
hygiene as the disease progresses.
Previous studies have shown that higher levels of antibodies
to periodontal bacteria are associated with an increase in levels of
inflammatory molecules elsewhere in the body. These inflammatory molecules have
been linked to greater rates of cognitive decline in Alzheimer's disease.
For the latest study, first study author Dr. Mark Ide, from
the Dental Institute at King's College London in the UK, and colleagues aimed
to determine whether periodontitis or gum disease is associated with increased
dementia severity and subsequent greater progression of cognitive decline in
people with Alzheimer's disease.
The researchers gathered 59 participants withmild to moderate Alzheimer's disease. Their cognitive function was
evaluated by taking cognitive tests and their blood sample was taken to measure
inflammatory markers in their blood. The majority of participants (52) were
followed-up at 6 months when all assessments were repeated.
The results showed that the presence of gum disease at study
baseline was not related to participants' cognitive state at that point.
However, it did appear to be associated to a six-fold increase in cognitive
decline over a six-month follow-up period. Additionally, participants who had
gum disease at study baseline showed an increase in blood levels of
pro-inflammatory markers over the follow-up period.
The authors suggest that gum disease is associated with an
increase in cognitive decline in Alzheimer's disease, possibly via mechanisms
linked to the body's inflammatory response.
Dr. Ide said:
"A number of studies have shown that having few teeth,
possibly as a consequence of earlier gum disease, is associated with a greater
risk of developing dementia. We also believe, based on various research findings
that the presence of teeth with active gum disease results in higher body-wide
levels of the sorts of inflammatory molecules which have also been associated
with an elevated risk of other outcomes such as cognitive decline or
cardiovascular disease. Research has suggested that effective gum treatment can
reduce the levels of these molecules closer to that seen in a healthy state."
Researchers admit that limitations of the study included the
small number of participants. They advise that the link between gum disease and
cognitive decline should be examined in a larger cohort. They said that the
precise mechanisms behind this association are not fully clear and other
factors might also play a part in the cognitive decline of participants.
