Association of periodontitis with cognitive decline and its progression: Contribution of blood‐based biomarkers of Alzheimer's disease to this relationship
Álvaro Carballo, Iria López‐Dequidt, Antía Custodia, João Botelho, Marta Aramburu‐Núñez, Vanessa Machado, Juan Manuel Pías‐Peleteiro, Alberto Ouro, Daniel Romaus‐Sanjurjo, Laura Vázquez‐Vázquez, Isabel Jiménez Martín, Pablo Aguiar, Manuel Rodríguez‐Yáñez, José Manuel Aldrey, Juan Blanco, José Castillo, Tomás Sobrino, Yago Leira
Abstract
Abstract Aim To assess whether periodontitis is associated with cognitive decline and its progression as well as with certain blood‐based markers of Alzheimer's disease. Materials and Methods Data from a 2‐year follow‐up prospective cohort study ( n = 101) was analysed. Participants with a previous history of hypertension and aged ≥60 years were included in the analysis. All of them received a full‐mouth periodontal examination and cognitive function assessments (Addenbrooke's Cognitive Examination (ACE) and Mini‐Mental State Examination [MMSE]). Plasma levels of amyloid beta (Aβ) 1‐40 , Aβ 1‐42 , phosphorylated and total Tau (p‐Tau and t‐Tau) were determined at baseline, 12 and 24 months. Results Periodontitis was associated with poor cognitive performance (MMSE: β = −1.5 [0.6]) and progression of cognitive impairment (hazard ratio [HR] = 1.8; 95% confidence interval: 1.0–3.1). Subjects with periodontitis showed greater baseline levels of p‐Tau (1.6 [0.7] vs. 1.2 [0.2] pg/mL, p < .001) and Aβ 1‐40 (242.1 [77.3] vs. 208.2 [73.8] pg/mL, p = .036) compared with those without periodontitis. Concentrations of the latter protein also increased over time only in the periodontitis group ( p = .005). Conclusions Periodontitis is associated with cognitive decline and its progression in elderly patients with a previous history of hypertension. Overexpression of p‐Tau and Aβ 1‐40 may play a role in this association.