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

Abstract

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.