The downward spiral of periodontitis and diabetes in Alzheimer's disease: Extending healthy life expectancy through oral health

Background: The Dominantly Inherited Alzheimer Network (DIAN) study revealed that the pathological changes associated with Alzheimer's disease (AD) begin decades before clinical symptoms occur. Therefore, attention has been focused on strategies to prevent AD progression. Evidence indicates that lifestyle related diseases, including diabetes and periodontitis, are risk factors for exacerbation of AD. Highlight: Low-grade chronic systemic inflammatory signals associated with periodontitis and diabetes may activate primed or senescent microglia, which may provoke an exaggerated neuroinflammation. Furthermore, periodontitis and diabetes are often concurrent diagnoses, and the bidirectional relationship may include underlying contributors that amplify the chronic systemic inflammatory signals required for AD progression. Conclusion: Effective management of periodontitis may contribute to prevention of AD, as periodontitis is both treatable and preventable. Therefore, brain health, which includes oral health as a contributing factor, is a promising strategy for achieving healthy life expectancy. (C) 2015 Japanese Association for Oral Biology. Published by Elsevier B.V. All rights reserved.