Author information

¹Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, NIA/NIH/IRP, Baltimore, Maryland, USA.

²U.S. Department of Veterans Affairs, VA National Center on Homelessness Among Veterans, Washington, District of Columbia, USA.

³Department of Management, Policy, and Community Health, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.

⁴Department of Psychology, Brigham Young University, Provo, Utah, USA.

⁵Department of Sociology, Brigham Young University, Provo, Utah, USA.

⁶Stanford Center on Longevity, Stanford University, Palo Alto, California, USA.

⁷Department of Biology, McGill University, Montreal, QC, Canada.

Abstract

Introduction: Relationships 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.

Methods: Less 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].

Results: Hepatitis 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.

Discussion: Select 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.