Infection burden, periodontal pathogens, and their interactive association with incident all‐cause and Alzheimer's disease dementia in a large national survey

Abstract

INTRODUCTIONRelationships and interplay of an infection burden (IB) and periodontal pathogens or periodontal disease (Pd) markers with Alzheimer's disease (AD) and all‐cause dementia among US adults were examined.METHODSLess than or equal to 2997 participants from the National Health and Nutrition Survey III were linked to CMS‐Medicare [≥45 years (1988‐1994); ≤30 years follow‐up].RESULTSHepatitis C (hazard ratio = 3.33, p = 0.004) and herpes simplex virus 2 were strongly associated with greater all‐cause dementia risk. Porphyromonas gingivalis and Streptococcus oralis were associated with greater AD risk at higher IB. The red‐green periodontal pathogen cluster coupled with higher IB count increased the risk of all‐cause dementia among minority racial groups. Pocket probing depth associated with dementia risk at lower IB in the overall sample.DISCUSSIONSelect viruses and bacteria were associated with all‐cause and AD dementia, while the IB interacted with Pd markers in relation to these outcomes.Highlights Interplay of infection burden (IB) and periodontal disease with dementia was tested. ≤2997 participants from NHANES III were linked to Medicare. Hepatitis C and herpes simplex virus 2 strongly associated with dementia risk. Tetanus sero‐positivity increased Alzheimer's disease (AD) risk. Porphyromonas gingivalis and Streptococcus oralis associated with AD at higher IB. Red‐green periodontal cluster at high IB, increased dementia in racial minorities. Pocket probing depth associated with dementia risk at lower IB.