The Correlation Between Severe Periodontal Disease And Mildcognitive Impairment And Alzheimer's Disease In Elderly Patients At Plateau

Objective To investigate the correlation between Mild cognitive impairment and Alzheimer's disease and severe periodontal disease in Qinghai-Tibet Plateau;To explore the risk factors and potential mechanisms of chronic oral infection in patients with MCI and AD in hypoxic environment.Methods Two hundred and seventy-one patients with severe periodontal disease and healthy people were collected in Institute of Geriatrics of Qinghai People's Hospital(mean sea level 2260 meters)from December 2015 to February 2017.According to the degree of periodontal disease and cognitive impairment were divided into four groups: control group,severe periodontal disease group,severe periodontal disease group +MCI,severe periodontitis+AD group.Serum biochemical parameters and periodontal clinical index were collected.Serum IL-1 and IL-6concentrations and gingival crevicular fluid were determined by ELISA assay.The detection rate of Porphyromonas gingivalis(Pg)in subgingival plaque was detected by fluorescent quantitative PCR assay.The data was analyzed by SPSS 21.0statistical software.Results 1.There was no significant difference in gender,age and education between the four groups(p>0.05);The scores of MMSE,Mo CA and ADAS-Cog scales in the four groups were statistically significant(p<0.05).2.The comparison of control group,serum Homocysteine(HCY)showed an upward trend with cognitive level decrease(p<0.05),Serum LDL-C level of severe periodontal disease group +AD was significantly increased compared to normal control group(p<0.05).3.Compared with the control group,Probing depth(PD),Clinical attachment level(CAL)and Bleeding index(BI)of three groups had linearly increased with the aggravation of periodontitis and cognition.The total detection rate of Pg in subgingival plaque was 65.68%,control group was 37.38%,severe periodontal disease group was 71.21%,severe periodontal disease group +MCI was 76.19%,severe periodontal disease group +AD was 94.23%(p<0.05).4.Serum and gingival crevicular fluid of IL-1?,IL-6 levels in severe periodontal disease,severe periodontal disease +MCI group and severe periodontal disease groups +AD group were statistically significantly increased compared with the control group(p<0.05),IL-6 levels of severe periodontal disease group + MCI and severe periodontal disease group + AD were significantly increased comparison of severe periodontal disease group(p<0.05).IL-1? and IL-6 level of gingival crevicular fluid were higher than serum the same inflammatory factors(p<0.05).5.By correlation analysis between clinical periodontal index,neural scale and IL-1?,IL-6,we found that PD and CAL were negatively correlated with MMSE,Mo CA,CDT(p<0.01),PD and CAL were positively correlated with ADAS-Cog(p<0.01),PD and CAL were positively correlated with IL-1?,IL-6 in serum and gingival crevicular fluid.Conclusions 1.High HCY and LDL-C levels may aggravated the cognitive impairment.2.There was the high detection rate of Pg in subgingival plaque of Severe periodontal disease with MCI and AD in Qinghai-Tibet Plateau.Meanwhile,serum and gingival crevicular fluid IL-1? and IL-6 level both groups were significantly increased.3.Severe periodontal disease and cognitive function had possible interaction in hypoxic environment.