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The aim of this study is to investigate the effect of the current periodontal status on the progression rate of AD.
Although much is known about its pathogenesis, Alzheimer's disease (AD) is still a terminal disease. For this reason, the correct evaluation and treatment of the risk factors of the disease gains importance in the prevention of the disease. Chronic inflammation, such as periodontal disease, can speed up the onset and progression of AD. The study aimed to investigate the relationship between periodontal status and the rate of progression of dementia in individuals diagnosed with Alzheimer's disease.
In this study, 90 individuals with AD, who were classified as Stage I, Stage II, and Stage III according to the Clinical Dementia Rating Scale. Baseline and 6th month cognitive status assessments of participants who met the inclusion criteria were performed in the Department of Neurology using SMMT. At the 6th month control appointment in the Neurology Department, the participants were referred to the Periodontology Department for oral examinations.
In the Periodontology Department, dental anamnesis of the patients was taken and intraoral examinations were performed. Periodontal examination of all existing teeth of all participants with at least one remaining tooth (excluding third molars) with a Williams-marked periodontal probe (Hu-Friedy, Chicago, Illinois, USA) and all molars and maxillary first premolars with Nabers probe (PQ2N, Hu-Friedy, Chicago, Illinois, USA) was performed and records %P (plak percentage), %BOP (percentage bleeding on probing), CAL (clinical attachment level), PPD (probing pocket depth). The position of the gingival margin and PPD were measured at six sites/teeth (including/excluding third molars). The CAL was then calculated from these measurements. In 2017, periodontal status was determined according to the decisions of the World Workshop on Periodontal and Peri-implant Diseases and Classification of Conditions. The current occlusal relationship status of all patients was evaluated using the Eichner Index and classified as Type 1 (A1-A2-A3-B1) , Type 2 (B2-B3) and Type 3 (B4-C1-C2-C3).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Stage I | Stage I Alzheimer's Group (n=42): Individuals diagnosed with probable Alzheimer's disease with mild (early stage) dementia according to the Clinical Dementia Rating Scale. |
| |
| Stage II | Stage II Alzheimer's Group (n=29): Individuals diagnosed with probable Alzheimer's disease with moderate (moderate stage) dementia according to the Clinical Dementia Rating Scale. |
| |
| Stage III | Stage III Alzheimer's Group (n=19): Individuals diagnosed with probable Alzheimer's disease with severe (advanced stage) dementia according to the Clinical Dementia Rating Scale. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Baseline Standardized Mini Mental Test | Diagnostic Test | Cognitive status assessment was done with Standardized Mini Mental Test. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in Standardized Mini Mental Test (SMMT) score at 6 months | The baseline SMMT score was recorded. After 6 months, the 6th month SMMT score was recorded. Change in SMMT score at 6 months= Baseline SMMT score-6th SMMT score. | Baseline and 6th month |
| Measure | Description | Time Frame |
|---|---|---|
| Alzheimer's disease stage | The stage of Alzheimer's disease was determined according to the clinical dementia rating scale. Stage I: Mild, Stage II: Moderate, Stage III: Severe. | Baseline |
| Gender |
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Inclusion Criteria:
Exclusion Criteria:
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Individuals diagnosed with mild/moderate/severe probable Alzheimer's disease according to the Clinical Dementia Rating Scale who meet the inclusion criteria
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| Name | Affiliation | Role |
|---|---|---|
| Ahmet AYDOÄžDU | Bezmialem Vakif University | Study Director |
| Özlem GELİŞİN | Bezmialem Vakif University | Study Chair |
| Şadiye GÜNPINAR | Bezmialem Vakif University | Study Chair |
| Kübra KARADURAN | Bezmialem Vakif University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bezmialem Vakif University | Istanbul | Fatih/Istanbul | 34093 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38159159 | Derived | Karaduran K, Aydogdu A, Gelisin O, Gunpinar S. Investigating the potential clinical impact of periodontitis on the progression of Alzheimer's disease: a prospective cohort study. Clin Oral Investig. 2023 Dec 30;28(1):67. doi: 10.1007/s00784-023-05445-w. |
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Data will be shared if requested.
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| ID | Term |
|---|---|
| D000544 | Alzheimer Disease |
| D010510 | Periodontal Diseases |
| D060825 | Cognitive Dysfunction |
| D010518 | Periodontitis |
| D001733 | Bites and Stings |
| ID | Term |
|---|---|
| D003704 | Dementia |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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| 6th month Standardized Mini Mental Test | Diagnostic Test | Cognitive status assessment was done with Standardized Mini Mental Test. |
|
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The gender distribution of Alzheimer's patients was divided into male and female.
| Baseline |
| Age | Ages of Alzheimer's patients were determined. | Baseline |
| Number of Alzheimer's patient with systemic disease | The current systemic conditions of Alzheimer's patients were evaluated and those with diabetes mellitus and cardiovascular disease were determined. | Baseline |
| Presence of periodontal disease | Alzheimer patients were evaluated according to the presence and absence of active periodontal disease. | 6th month |
| Plaque percentage (%P) | It is an index that shows the amount of microbial dental plaque on the teeth. | 6th month |
| Bleeding on probing percentage (%BOP) | Bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus. | 6th month |
| Periodontal probing depth (PPD) (mm) | The distance from the gingival margin to pocket base. | 6th month |
| Clinical attachment level (CAL) (mm) | The clinical attachment level is the distance between the enamel-cementum junction and the gingival sulcus. | 6th month |
| Number of teeth | The number of teeth present in Alzheimer's patients was determined. | 6th month |
| Occlusal relationship type | Alzheimer's patients were classified according to the Eichner Index (A1-A2-A3-B1-B2-B3-B4-C1-C2-C3). They were evaluated according to their occlusal relationship status and classified as Type 1, Type 2 and Type 3.
| 6th month |
| C-Reactive Protein (CRP) (mg/l) | C-Reactive Protein (CRP) is a protein found in blood plasma whose circulating concentration is associated with inflammation. | between baseline and -6th month |
| Neutrophil ratio (NEUT%) | It refers to the percentage of circulating neutrophils to total white blood cells. | between baseline and -6th month |
| Lymphocyte ratio (LYMPH%) | It refers to the percentage of circulating lymphocytes to total white blood cells. | between baseline and -6th month |
| Neutrophil count (10*3/uL) | It is demonstrates the number of neutrophils in the peripheral blood. | between baseline and -6th month |
| Lymphocyte count (10*3/uL) | It is demonstrates the number of lymphocytes in the peripheral blood. | between baseline and -6th month |
| Neutrophil-to-lymphocyte ratio (NLR) | Neutrophil-to-lymphocyte ratio (NLR) is calculated by dividing the absolute number of neutrophils by absolute number of lymphocytes. | between baseline and -6th month |
| Mean platelet volume (fL) (MPV) | Mean platelet volume (MPW) is a measure of the average size of the platelets. | between baseline and -6th month |
| Platelet distribution width (fL) (PDW) | Platelet distribution width (PDW) reflects the variability in platelet size distribution. | between baseline and -6th month |
| D024801 |
| Tauopathies |
| D019636 | Neurodegenerative Diseases |
| D019965 | Neurocognitive Disorders |
| D001523 | Mental Disorders |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D003072 | Cognition Disorders |
| D011041 | Poisoning |
| D064419 | Chemically-Induced Disorders |
| D014947 | Wounds and Injuries |