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Periodontal pathogens and their association with incident all‐cause and Alzheimer’s disease dementia in a large national survey
Author(s) -
Beydoun May A,
Beydoun Hind A,
Hossain Sharmin A,
ElHajj Ziad W,
Weiss Jordan,
Zonderman Alan
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.036141
Subject(s) - medicine , prevotella intermedia , periodontal pathogen , incidence (geometry) , dementia , national death index , fusobacterium nucleatum , national health and nutrition examination survey , porphyromonas gingivalis , immunology , clinical attachment loss , periodontitis , disease , population , hazard ratio , confidence interval , physics , environmental health , optics
Background Infectious agents including periodontal pathogens have recently appeared as important actors in Alzheimer’s Disease (AD) pathology. We examined associations of serum immunoglobulin G (IgG) against periodontal pathogens and Pd markers with incident all‐cause and AD dementia as well as AD mortality among U.S. middle‐aged and older adults. Method Periodontal disease (Pd) markers [Clinical Attachment Loss (CAL); probing depth and periodontal pathogen immunoglobulin G (IgG)] were investigated in relation to AD and all‐cause dementia incidence and to AD mortality, using data from the third National Health and Nutrition Examination Surveys (NHANES III, 1988‐1994) linked longitudinally with National Death Index and Medicare data through January 1 st , 2014, with up to 26y of follow‐up. Sex‐ and age group‐specific multivariable‐adjusted Cox proportional hazards models were conducted. Result Among those ≥65y, AD incidence and mortality were consistently associated with probing depth, two factors and one cluster comprised of IgG titers against Porphyromonas gingivalis ( Pg ), Prevotella melaninogenica ( Pm ) and Campylobacter rectus ( Cr ) among others. Specifically, AD incidence was linked to a composite of Cr and Pg titers (per SD, aHR=1.22; 95% CI, 1.04‐1.43, P=0.012), while AD mortality risk was increased with another composite (per SD, aHR=1.46; 95% CI, 1.09‐1.96, P=0.017) loading highly on Pg , Prevotella intermedia , Prevotella nigrescens , Fusobacterium nucleatum , Cr , Streptococcus intermedius , Capnocylophaga Ochracea and Pm . Conclusion This study provides evidence for an association between periodontal pathogens and AD, which was stronger for older adults. Effectiveness of periodontal pathogen treatment on reducing sequelae of neurodegeneration should be tested in randomized controlled trials.