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Unlocking Modifiable Risk Factors for Alzheimer’s Disease: Does the Oral Microbiome Hold Some of the Keys?
journal contribution
posted on 2023-04-28, 06:43 authored by Amy Loughman, Christina J Adler, Helen MacphersonHelen MacphersonAdvancing age is recognized as the primary risk factor for Alzheimer’s disease (AD); however approximately one third of dementia cases are attributable to modifiable risk factors such as hypertension, diabetes, smoking, and obesity. Recent research also implicates oral health and the oral microbiome in AD risk and pathophysiology. The oral microbiome contributes to the cerebrovascular and neurodegenerative pathology of AD via the inflammatory, vascular, neurotoxic, and oxidative stress pathways of known modifiable risk factors. This review proposes a conceptual framework that integrates the emerging evidence regarding the oral microbiome with established modifiable risk factors. There are numerous mechanisms by which the oral microbiome may interact with AD pathophysiology. Microbiota have immunomodulatory functions, including the activation of systemic pro-inflammatory cytokines. This inflammation can affect the integrity of the blood-brain barrier, which in turn modulates translocation of bacteria and their metabolites to brain parenchyma. Amyloid-β is an antimicrobial peptide, a feature which may in part explain its accumulation. There are microbial interactions with cardiovascular health, glucose tolerance, physical activity, and sleep, suggesting that these modifiable lifestyle risk factors of dementia may have microbial contributors. There is mounting evidence to suggest the relevance of oral health practices and the microbiome to AD. The conceptual framework presented here additionally demonstrates the potential for the oral microbiome to comprise a mechanistic intermediary between some lifestyle risk factors and AD pathophysiology. Future clinical studies may identify specific oral microbial targets and the optimum oral health practices to reduce dementia risk.
History
Journal
Journal of Alzheimer's DiseaseVolume
92Pagination
1-19Location
NetherlandsPublisher DOI
ISSN
1387-2877eISSN
1875-8908Language
engIssue
4Publisher
IOS PressUsage metrics
Keywords
Alzheimer’s diseasedementiahealthy lifestylemicrobiotaoral healthperiodontal diseasesDementiaAlzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD)NeurodegenerativeAcquired Cognitive ImpairmentDental/Oral and Craniofacial DiseaseNutritionObesityPreventionAgingCardiovascularClinical ResearchBrain DisordersAlzheimer's DiseaseNeurosciences2 Aetiology2.1 Biological and endogenous factorsNeurological3 Good Health and Well BeingCognitive SciencesClinical Sciences not elsewhere classifiedNeurosciences not elsewhere classified
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