Analyzing the relationship between periodontal health status and alzheimer's disease

Although much is known about the pathogenesis of Alzheimer's disease (AD), it has still no precise treatmeent. Therefore, the correct evaluation of the risk factors of the disease gains importance in the prevention of the disease.It is thought that chronic inflammatory diseases such as periodontal disease may accelerate the onset and progression of AD. For this reason, the aim of this study is to investigate the effect of the current periodontal status on the progression rate of AD. A total of 90 Alzheimer's patients, who were divided into three groups as Stage 1 (n=42), Stage 2 (n=29) and Stage 3 (n=19) based on the Clinical Dementia Rating Scale, were included in the study. Cognitive status of the patients at baseline and 6th month were evaluated with the Standardized Mini-Mental Test (SMMT). In clinical examination, plaque percentage (PP), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL) values and the number of teeth were recorded. The current occlusal relationship status of the individuals was evaluated using the Eichner Index, and the patients were classified as Type 1, Type 2, and Type 3. In this study, of 90 Alzheimer's patients, 65 were toothed individuals with periodontitis and 25 were edentulous individuals without active periodontal disease. It was determined that there was a significant difference between the groups in terms of age of Alzheimer's patients (p<0.05), on the other hand, there was no statistically significant differrence in terms of gender (p>0.05). When SMMT scores and SMMT score changes (∆SMMT) were evaluated in all participants and in patients with toothed Alzheimer's alone, it was determined that there was a significant difference between the groups (p<0.05). On the other hand, ∆SMMT of edentulous Alzheimer's patients did not differ between the groups (p>0.05). BOP in patients with toothed Alzheimer's was significantly higher in Stage 3 Alzheimer's group than in other groups, and CAL value were significantly higher in Stage 3 and Stage 2 Alzheimer's patients than in Stage 1 Alzheimer's patients (p<0.05). In addition, PPD value were found to be significantly higher in Stage 3 Alzheimer's patients than in Stage 1 Alzheimer's patients (p>0.05). A positive correlation was found between ∆SMMT and BOP (r=0.308, p=0.013) and PPD (r=0.275, p=0.027). When the effect of stage of AD, age, presence of periodontal disease and C-reactive protein levels on ∆SMMT were evaluated together, it was determined that the individuals being in the Stage 2 and Stage 3 Alzheimer's group, the age variable and the presence of periodotal disease had a significant effect (p<0.05). Within the limits of our study, it can be concluded that presence of periodontitis may increase the severity and rate of the progression of Alzheimer's disease. Keywords: Alzheimer's Disease, cognitive decline, periodontal disease, periodontitis, occlusion, chewing