Serum antibodies to periodontal pathogens are a risk factor for Alzheimer's disease

Pamela Sparks Stein, Michelle J. Steffen, Charles Smith, Gregory Jicha, Jeffrey L. Ebersole, Erin Abner, Dolph Dawson

Research output: Contribution to journalArticlepeer-review

341 Scopus citations


Background: Chronic inflammation in periodontal disease has been suggested as a potential risk factor in Alzheimer's disease (AD). The purpose of this study was to examine serum antibody levels to bacteria of periodontal disease in participants who eventually converted to AD compared with the antibody levels in control subjects. Methods: Serum samples from 158 participants in the Biologically Resilient Adults in Neurological Studies research program at the University of Kentucky were analyzed for immunoglobulin G antibody levels to seven oral bacteria associated with periodontitis, including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Campylobacter rectus, Treponema denticola, Fusobacterium nucleatum, Tannerella forsythia, and Prevotella intermedia. All 158 participants were cognitively intact at baseline venous blood draw. In all, 81 of the participants developed either mild cognitive impairment (MCI) or AD or both, and 77 controls remained cognitively intact in the years of follow-up. Antibody levels were compared between controls and subjects with AD at baseline draw and after conversion and controls and subjects with MCI at baseline draw and after conversion using the Wilcoxon rank-sum test. AD and MCI participants were not directly compared. Linear regression models were used to adjust for potential confounding. Results: Antibody levels to F nucleatum and P intermedia were significantly increased (α = 0.05) at baseline serum draw in the patients with AD compared with controls. These results remained significant when controlling for baseline age, Mini-Mental State Examination score, and apolipoprotein epsilon 4 status. Conclusions: This study provides initial data that demonstrate elevated antibodies to periodontal disease bacteria in subjects years before cognitive impairment and suggests that periodontal disease could potentially contribute to the risk of AD onset/progression. Additional cohort studies profiling oral clinical presentation with systemic response and AD and prospective studies to evaluate any cause-and-effect association are warranted.

Original languageEnglish
Pages (from-to)196-203
Number of pages8
JournalAlzheimer's and Dementia
Issue number3
StatePublished - May 2012

Bibliographical note

Funding Information:
This study was supported in part by National Institutes of Health (NIH)/National Institute on Aging 1 P30 AG028383 , NIH/National Center for Research Resources P20 , NIH #5-P30-AG028383 , and contract #PO 2728090002347411 from the Kentucky Department of Public Health .


  • Alzheimer's disease
  • Antibody
  • Mild cognitive impairment
  • Periodontal bacteria
  • Periodontal disease
  • Periodontitis

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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