Effect of periodontal treatment on preclinical Alzheimer's disease-Results of a trial emulation approach

Alzheimers Dement. 2022 Jan;18(1):127-141. doi: 10.1002/alz.12378. Epub 2021 May 29.


Introduction: We investigated the relationship between periodontal treatment and pre-clinical Alzheimer's disease (AD).

Methods: In this quasi-experimental design, 177 periodontally treated patients from the "Greifswald Approach to Individualized Medicine" cohort, which used the same protocols as the population-based Study of Health in Pomerania TREND (SHIP-TREND), and 409 untreated subjects from SHIP-TREND were analyzed. Subjects were younger than 60 years at the magnetic resonance imaging examination, with a median observation period of 7.3 years. Imaging markers for brain atrophy in late-onset AD and brain aging were used as the outcomes.

Results: Robust to sensitivity analyses, periodontal treatment had a favorable effect on AD-related brain atrophy (-0.41; 95% confidence interval: -0.70 to -0.12; P = .0051), which corresponds to a shift from the 50th to the 37th percentile of the outcome distribution. For brain aging, the treatment effect was uncertain.

Conclusion: Periodontitis is related to pre-clinical AD in our population.

Keywords: Alzheimer's disease; aging; epidemiology; magnetic resonance imaging; periodontal diseases.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Aging / pathology
  • Alzheimer Disease / pathology
  • Atrophy / pathology*
  • Brain / pathology*
  • Cohort Studies
  • Female
  • Germany / epidemiology
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Periodontal Diseases / epidemiology*
  • Prodromal Symptoms*
  • Risk Factors