알츠하이머병과 구강 질환, 무엇이 먼저인가?:알츠하이머병 위험 인자로서의 구강 질환에 관한 고찰

Abstract

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common form of dementia in the elderly population, with increasing prevalence and substantial socioeconomic burden. Recent studies have identified poor oral health, particularly periodontal disease, as emerging risk factors for AD. Periodontitis, characterized by chronic inflammation and microbial dysbiosis, may contribute to AD pathogenesis through systemic inflammation, neuroinflammatory responses, and disruption of the blood-brain barrier (BBB), facilitated by pathogens such as Porphyromonas gingivalis and associated proinflammatory cytokines. These mechanisms have been shown to enhance amyloid-β (Aβ) production and tau hyperphosphorylation (p-tau), key pathological features of AD. Additionally, the APOE4 allele may increase susceptibility to inflammatory responses and exacerbate the link between periodontal disease and AD. Tooth loss and lack of denture use have also been associated with increased risk of cognitive decline and dementia, potentially due to impaired mastication and nutritional deficiencies. Based on this evidence, prevention and management of oral diseases, along with appropriate prosthetic rehabilitation, may serve as effective secondary strategies for the prevention and progression control of Alzheimer’s disease.