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Complete loss of teeth: a newly identified risk factor for Alzheimer‘s Disease ? The Neuburg Dementia Trial

Dienel, Max, M.D. e-mail: max.dienel@geriatriezentrum.de
Geriatric-Rehabilitation-Center, Neuburg an der Donau, Germany.

Objective: Do patients with Alzheimer‘s disease have fewer teeth than patients without dementia? [1]

Method: 1038 patients were checked for the number of remaining teeth, the Mini-Mental-State (MMS) and the Barthelindex (Barthel). Using ICD-10-criteria, Alzheimer‘s disease (N=124), Vascular dementia (N=34) and both types of dementia simultaneously (N=26) were diagnosed.

Results: Patients diagnosed with severe Alzheimer‘s disease (MMS<=20,Barthel<=70,average age83.3;N=69) averaged 0.2 teeth.
Patients diagnosed with mild Alzheimer‘s disease (MMS>20,Barthel>70,age82.2;N=55) averaged 1.5 teeth. Patients of the same age with no signs of dementia (MMS>25,age82.9;N=20) averaged 4.7 teeth.
Patients diagnosed with Vascular dementia were younger (age78.4) and averaged 6.9 teeth. By comparison, the 99 patients with cerebral infarction had 6.7 teeth left (age78.4).
Conclusions: Patients diagnosed with severe Alzheimer‘s disease showed a 20-fold increase in tooth loss compared to controls (0.2 versus 4.7 teeth, respectively; p<0.0001).
As sugar-rich diet is a well established cause of caries [2,3], this might suggest that lifelong better nutritional habits may help to avoid Alzheimer‘s disease [4].

References:
[1] Kondo K, Niino M, Shido K (1994): A case-control study of Alzheimer‘s disease in Japan‘significance of life-styles. Dementia Nov-Dec;5(6):314-26
[2] Splieth C, Meyer G (1996): Factors for changes of caries prevalence among adolescents in Germany. Eur J Oral Sci Aug;104(4(Pt2)):444-51
[3] Johansson I, Tidehag P, Lundberg V, Hallmans G (1994): Dental status, diet and cardiovascular risk factors in middle-aged people in northern Sweden. Community Dent Oral Epidemiol Dec;22(6):431-36
[4] Nourhashemi F et al. (2000) : Alzheimer disease : protective factors. Am J Clin Nutr Feb;71(2):643-49