CDM Researcher Finds Link Between Oral Health and Dementia

There is a clear link between poor periodontal health and brain magnetic resonance imaging (MRI) markers of Alzheimer’s disease and cognitive aging, according to research recently published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association by Panos N. Papapanou, DDS, PhD, professor of dental medicine, James Noble, MD, MS, associate professor at CUIMC and neurologist at the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, and their co-investigators at the Vagelos College of Physicians and Surgeons.

The research analyzed 468 participants with clinical periodontal data, oral microbial plaque and serum samples, and brain MRIs, and tested the association between features of periodontitis and MRI findings, leveraging patient data from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a study of cognitive aging that has serially assessed more than 6,000 people in the northern Manhattan neighborhoods adjacent to the Columbia University Irving Medical Center.

As part of the ongoing, NIH-funded WHICAP Ancillary Study of Oral Health co-led by the two investigators, study participants received oral examinations and were assessed for periodontal bacterial plaques and serum

antibodies to periodontal microbiota. After adjusting for multiple established risk factors, the researchers showed that multiple features of periodontitis were associated with unfavorable MRI findings seen in Alzheimer's disease and related dementias (AD/ADRD).

Panos N. Papapanou, DDS, PhD

“This is the first epidemiological study to examine associations between clinical, microbial and serological features of periodontitis and structural MRI findings related to AD/ADRD” Papapanou says. Interestingly, specific subgingival bacteria were found to be either favorably or unfavorably associated with certain MRI features.

Although the research does not draw a direct causal connection between periodontitis and Alzheimer’s disease, a link is biologically plausible , Papapanou says, “because untreated periodontitis leads to elevated systemic inflammation, which may tie the two conditions together. Additional prospective studies are warranted, and the ongoing WHICAP Ancillary Study of Oral Health is uniquely well positioned to examine whether poor periodontal health is associated with worsening cognitive status over time”.

Papapanou emphasizes that the research has significant public health implications. Periodontitis is highly prevalent among elderly Americans, and especially among those who have limited access to oral healthcare. “There are data that demonstrate that people who take care of their oral health have lower general health care expenditures,” he says. “Taking care of your mouth is important for your oral health and function, but also an integral part of general wellbeing as people age.”