Dental Carotid Cognitive Study
Periodontal disease, an infection of tissues that hold teeth in place, is associated with several conditions, such as atherosclerosis and diabetes, common in older people with mild to moderate cognitive impairment (MCI). These individuals are also prone to poor oral hygiene and dental health, which, if untreated, worsens inflammation-mediated brain and nervous system function and accelerates progression to dementia. Asymptomatic carotid artery stenosis (ACAS) may have a strong association with MCI. This study examines the effects of intensive therapy for periodontal disease on cognition in high-risk older people with ACAS.
|Minimum Age||Maximum Age||Gender||Healthy Volunteers|
|60 Years||100 Years||All||No|
- Body Mass Index of 18-35
- Mild to moderate periodontal disease
- Mild to moderate cognitive impairment
- Detectable carotid plaque and carotid artery stenosis less than 70 percent
- Able to perform prescribed dental hygiene
- Inability to provide informed consent or to perform cognitive and other research testing
- Prior stroke, depression, or neurological or psychiatric disease that would affect cognitive testing, participation, and compliance with the research study
- Chronic treatment with systemic corticosteroids or other systemic immunosuppressive drugs or drugs that would affect the dental treatments in the study
- Need for essential dental care (e.g., treatment for grossly decayed teeth, broken teeth, dental abscesses, peri-apical infections, other dental infections)
- Inability to perform FDG-PET brain scan due to renal disease
- Receiving anticoagulant therapy at time of dental treatment or with a bleeding disorder/other diseases that may interfere with dental therapy
This pilot study examines the hypothesis that intensive treatment of periodontal disease in older people with MCI and ACAS will lessen their cognitive decline by reducing oral microbial-mediated inflammation that contributes to dementia. The aims are to determine the effects of intensive vs. standard treatment for periodontal disease on cognitive function and quality of life and to determine the potential mechanisms mediating these effects.
Participants receiving intensive treatment will have gingival scaling and root planing, plus oral hygiene instruction. Additional sessions will be added as necessary to address remaining problems and treat inflammation and bacteria overgrowth. Each participant will be instructed to use half of a capful of 0.12% chlorhexidine twice a day during active treatment, including 2 weeks beyond the treatment visit.
University of Maryland - Administrative Center
Kimberlly A Nordstrom, CCRC
University of Maryland, Baltimore
- University of Maryland, College Park
- Baltimore VA Medical Center
|Kimberlly Nordstrom, CCRC||Study Director||University of Maryland, College Park|
|Laila Anthony, BSfirstname.lastname@example.org|
Treatment of Periodontitis to Prevent Dementia in Older Adults With Asymptomatic Carotid Artery Stenosis and Mild Cognitive Impairment
- Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, Iadecola C, Launer LJ, Laurent S, Lopez OL, Nyenhuis D, Petersen RC, Schneider JA, Tzourio C, Arnett DK, Bennett DA, Chui HC, Higashida RT, Lindquist R, Nilsson PM, Roman GC, Sellke FW, Seshadri S; American Heart Association Stroke Council, Council on Epidemiology and Prevention, Council on Cardiovascular Nursing, Council on Cardiovascular Radiology and Intervention, and Council on Cardiovascular Surgery and Anesthesia. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association. Stroke. 2011 Sep;42(9):2672-713. doi: 10.1161/STR.0b013e3182299496. Epub 2011 Jul 21. Review.
- Smith JA, Das A, Ray SK, Banik NL. Role of pro-inflammatory cytokines released from microglia in neurodegenerative diseases. Brain Res Bull. 2012 Jan 4;87(1):10-20. doi: 10.1016/j.brainresbull.2011.10.004. Epub 2011 Oct 18. Review.
- Leszek J, Barreto GE, Gsiorowski K, Koutsouraki E, vila-Rodrigues M, Aliev G. Inflammatory Mechanisms and Oxidative Stress as Key Factors Responsible for Progression of Neurodegeneration: Role of Brain Innate Immune System. CNS Neurol Disord Drug Targets. 2016;15(3):329-36. Review.
- Miklossy J, McGeer PL. Common mechanisms involved in Alzheimer's disease and type 2 diabetes: a key role of chronic bacterial infection and inflammation. Aging (Albany NY). 2016 Apr;8(4):575-88. doi: 10.18632/aging.100921. Review.
- Otomo-Corgel J, Pucher JJ, Rethman MP, Reynolds MA. State of the science: chronic periodontitis and systemic health. J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):20-8. doi: 10.1016/S1532-3382(12)70006-4. Review.
- Daulatzai MA. Cerebral hypoperfusion and glucose hypometabolism: Key pathophysiological modulators promote neurodegeneration, cognitive impairment, and Alzheimer's disease. J Neurosci Res. 2017 Apr;95(4):943-972. doi: 10.1002/jnr.23777. Epub 2016 Jun 27. Review.
- Teixeira FB, Saito MT, Matheus FC, Prediger RD, Yamada ES, Maia CSF, Lima RR. Periodontitis and Alzheimer's Disease: A Possible Comorbidity between Oral Chronic Inflammatory Condition and Neuroinflammation. Front Aging Neurosci. 2017 Oct 10;9:327. doi: 10.3389/fnagi.2017.00327. eCollection 2017. Review.
- Fouad A, Mongodin E, Hittle L, et al. Microbiome analysis of oral and atheromatous plaques in atherosclerotic patients. In: IADR General Session and Exhibition. 2014
- Emery DC, Shoemark DK, Batstone TE, Waterfall CM, Coghill JA, Cerajewska TL, Davies M, West NX, Allen SJ. 16S rRNA Next Generation Sequencing Analysis Shows Bacteria in Alzheimer's Post-Mortem Brain. Front Aging Neurosci. 2017 Jun 20;9:195. doi: 10.3389/fnagi.2017.00195. eCollection 2017.
- Caminiti SP, Ballarini T, Sala A, Cerami C, Presotto L, Santangelo R, Fallanca F, Vanoli EG, Gianolli L, Iannaccone S, Magnani G, Perani D; BIOMARKAPD Project. FDG-PET and CSF biomarker accuracy in prediction of conversion to different dementias in a large multicentre MCI cohort. Neuroimage Clin. 2018 Jan 28;18:167-177. doi: 10.1016/j.nicl.2018.01.019. eCollection 2018.
- Ide M, Harris M, Stevens A, Sussams R, Hopkins V, Culliford D, Fuller J, Ibbett P, Raybould R, Thomas R, Puenter U, Teeling J, Perry VH, Holmes C. Periodontitis and Cognitive Decline in Alzheimer's Disease. PLoS One. 2016 Mar 10;11(3):e0151081. doi: 10.1371/journal.pone.0151081. eCollection 2016.