Oral frailty and neurodegeneration in Alzheimer's disease

Antonio Daniele, Vittorio Dibello, Madia Lozupone, Daniele Manfredini, Antonio Dibello, Roberta Zupo, Rodolfo Sardone, Frank Lobbezoo, Francesco Panza

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Frailty is a critical intermediate status of the aging process with a multidimensional and multisystem nature and at higher risk for adverse health-related outcomes, including falls, disability, hospitalizations, institutionalization, mortality, dementia, and Alzheimer's disease. Among different frailty phenotypes, oral frailty has been recently suggested as a novel construct defined as a decrease in oral function with a coexisting decline in cognitive and physical functions. We briefly reviewed existing evidence on operational definitions of oral frailty, assessment and screening tools, and possible relationships among oral frailty, oral microbiota, and Alzheimer's disease neurodegeneration. Several underlying mechanism may explain the oral health-frailty links including undernutrition, sarcopenia linked to both poor nutrition and frailty, psychosocial factors, and the chronic inflammation typical of oral disease. Oral microbiota may influence Alzheimer's disease risk through circulatory or neural access to the brain and the interplay with periodontal disease, often causing tooth loss also linked to an increased Alzheimer's disease risk. On this bases, COR388, a bacterial protease inhibitor targeting Porphyromonas gingivalis implicated in periodontal disease, is now being tested in a double-blind, placebo-controlled Phase II/III study in mild-to-moderate Alzheimer's disease. Therefore, oral status may be an important contributor to general health, including Alzheimer's disease and late-life cognitive disorders, suggesting the central role of preventive strategies targeting the novel oral frailty phenotype and including maintenance and improvement of oral function and nutritional status to reduce the burden of both oral dysfunction and frailty.
Lingua originaleEnglish
pagine (da-a)2149-2153
Numero di pagine5
RivistaNeural Regeneration Research
Volume16
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • biomarkers
  • cognitive frailty
  • dementia
  • diet
  • tooth loss
  • nutritional frailty
  • oral health
  • oral microbiota
  • periodontal disease
  • mild cognitive impairment

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