Abstract
Background: Although clinical studies have shown an increased prevalence of primary open-angle glaucoma (POAG) in patients with Alzheimer’s disease (AD), a population-based epidemiologic study from Denmark found no increased risk of Alzheimer’s disease in patients with glaucoma, and other studies have failed to demonstrate a link. However, a possible relationship between POAG and AD might manifest in their association with oral pathology. Dental caries, periodontal disease, stomatitis, and the related inflammatory burden increase AD risk, while oral pathology and the oral microbiome correlate with POAG vulnerability. To further examine the relationship, we analyzed POAG, AD, and oral disease in the UK Biobank (UKBB) cohort.Methods: Our analysis included all subjects with POAG and AD. POAG diagnosis was ascertained using the 10th Revision of the International Classification of Diseases (ICD-10), H40.11. AD diagnosis was ascertained using the 10th Revision of the International Classification of Diseases (ICD-10), G30. Oral cavity, ulceration, stomatitis, periodontitis, teeth, and dental problems were in UKBB data field 6149.Results: A “yes” answer to a question about bleeding gums is associated with a greater proportional POAG reduction (24.2%) than a “yes” answer to having none of the six listed problems (6.3%). Similarly, bleeding gums were associated with a greater proportional AD reduction (46.2% versus 16.9%). Logistic regression controlling for age and sex showed that bleeding gums (no/yes) were negatively associated with AD (odds ratio (OR) = 0.713, 95% confidence interval (CI) = 0.521-0.976, p = 0.035). Age-weighted least-squares linear regression showed that the lower corneal-compensated intraocular pressure (IOP) in the left eye was associated with bleeding gums (unstandardized regression coefficient = -0.174, p < 0.001), controlling for type 2 diabetes and past smoking.Conclusion: It is difficult to predict what component or components of periodontal inflammation might be ameliorating POAG and AD. Prostaglandin is a possibility. Identification of the component or components could lead to new treatments for POAG and AD. Further studies are warranted.
Highlights
Glaucoma is a collection of ocular neuropathies marked by the degeneration of retinal ganglion cells (RGCs) and their axons, which results in a distinctive optic nerve appearance and visual field abnormalities
A “yes” answer to a question about bleeding gums is associated with a greater proportional primary open-angle glaucoma (POAG) reduction (24.2%) than a “no” answer (6.3%)
The major periodontal pathogens Porphyromonas gingivalis, a keystone pathobiont in periodontitis, and Bacteroides forsythus and their bacterial components have been found in the brains of patients with Alzheimer’s disease (AD) and seem to provoke the inflammation that is a feature of AD [9]
Summary
Glaucoma is a collection of ocular neuropathies marked by the degeneration of retinal ganglion cells (RGCs) and their axons, which results in a distinctive optic nerve appearance and visual field abnormalities. The most prevalent type of glaucoma is primary open-angle glaucoma (POAG). The most prevalent cause of dementia in the elderly is Alzheimer’s disease (AD), a neurodegenerative condition that develops over time and is defined clinically as growing cognitive and behavioral impairment. Clinical studies have shown an increased prevalence of primary open-angle glaucoma (POAG) in patients with Alzheimer’s disease (AD), a population-based epidemiologic study from Denmark found no increased risk of Alzheimer’s disease in patients with glaucoma, and other studies have failed to demonstrate a link. A possible relationship between POAG and AD might manifest in their association with oral pathology. Periodontal disease, stomatitis, and the related inflammatory burden increase AD risk, while oral pathology and the oral microbiome correlate with POAG vulnerability. To further examine the relationship, we analyzed POAG, AD, and oral disease in the UK Biobank (UKBB) cohort
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