The Characteristics Of Oral Microbiota In Mild Alzheimer’s Patients And The Effects Of Oral Health Intervention Strategies

Objective:Subgingival plaque of patients with mild Alzheimer’s disease was detected by 16 S r DNA sequencing technology.Species information of oral microbiome was analyzed to clarify oral health status,cognitive level and characteristics of oral microbiome.Based on the characteristics of oral microbiome as biological basis,combined with cognitive reserve hypothesis,self-determination theory and neuroinflammation theory,oral health intervention strategies were designed and implemented to explore the positive effects on oral microbiome and cognitive function of patients with Alzheimer’s disease and delay the progression of AD disease.Methods:Part 1: Included in the evaluation of clinical dementia rating scale of 1 100 patients with mild alzheimer’s disease,and use simple oral health screening table,evaluate the oral health status,simple mental state checklist to assess their cognitive level,16 s r DNA sequencing technology to detect 100 cases of gingival plaque samples,table score into two groups according to oral health screening,analysis of oral health status,cognitive level,and the different characteristics of microbial communities.Part 2: A randomized controlled trial to study the efficacy of oral health intervention strategies in patients with Alzheimer’s disease.Based on the characteristics of oral microbiome in the first part,66 patients with mild Alzheimer’s disease were selected and randomly divided into two groups.Combined with cognitive reserve hypothesis,self-determination theory and neuroinflammation theory,the oral health intervention strategy was designed and implemented.Using concise table to assess the oral health status and oral health screening simple mental state checklist to assess their cognitive level,pension institutions mental adjustment scale to assess their mental health in the elderly,neuropsychological scale to assess its nerve mental symptoms,alzheimer’s disease collaborative research ability scale to evaluate their ability of daily life,daily life 16 s r DNA sequencing technology to detect alzheimer’s patients plaque samples under the gum,analysis of oral health intervention strategies for the effects of oral microbiota and cognitive function.Results:Part 1: There were no significant differences between the two groups in age,education level,gender,marital status,occupation,history of hypertension,body mass index(BMI)and number of active dentures(P>0.05).There were significant differences in diabetes history(P=0.032),number of natural teeth(P=0.002),oral health score(P=0.000)and simple mental state score(P=0.048).Two sets of samples in the level of species abundance is more than 1% of the bacteria genera including streptococcus,neisseria 、 prevotella 、 leptotrichia 、 veillonella 、 fusobacterium 、 capnocytophag 、selenomonas、porphyromonas、saccharibacteria＿genera＿incertae＿sedis、haemophilus,rothia、campylobacter,corynebacterium、aggregatibacter、treponema for about 83% of the total bacteria.Species analysis of different flora between the two groups showed that the species with poor oral condition had lower abundance.Part 2: There was no significant difference in baseline data between the two groups(P >0.05).After 24 weeks of oral health intervention,the scores of oral health(P=0.000),simple mental state scale(P=0.030),neuropsychiatric scale(P=0.001),mental adjustment scale for the elderly(P=0.030),and daily living ability scale for the Alzheimer’s disease collaboration study(P=0.000)were significantly different between the experimental group and the control group.Experimental group in the measurement of the baseline to 24 weeks within the group has significant difference,oral health(P =0.000),simple mental state scale(P = 0.034),nerve mental scale(P= 0.000),alzheimer’s disease cooperative study daily life ability scale score(P = 0.007)were lower than the baseline levels,mental adjustment scale score(P=0.000)in the elderly is higher baseline,the control group in the measurement of the baseline to 24 weeks had significant differences in the group,The scores of the Simple Mental State Scale(P=0.000),the Mental Adjustment Scale for the Elderly(P=0.017),the Alzheimer’s Disease Collaborative Study Daily Living Scale(P=0.000)were lower than the baseline,and the scores of the Oral Health Scale(P=0.000)and the Neuropsychiatric Scale(P=0.025)were higher than the baseline.There were significant differences in the diversity and abundance of the flora.Two sets of samples in the level of species abundance is more than 1% of the species including prevotella 、 fusobacterium 、 burkholderia 、streptococcus、neisseria、porphyromonas、veillonell、phenylobacterium、leptotrichia、capnocytophaga、campylobacter、haemophilus、selenomonas、rothia 、treponema、actinomyces、aggregatibacter、lautropia、kingella accounted for more than 83.19%.Different species analysis of the two groups showed that the abundance of oral normal flora in the experimental group was higher than that in the control group,while the number of pathogenic bacteria decreased.Conclusion:By 16 s r DNA sequencing technology to detect light under the gum of plaque in patients with alzheimer’s disease to understand oral microbial community characteristics,as a biological basis,in alzheimer’s patients physiological and psychological characteristics design targeted oral health intervention strategies,the change of effective oral microbiota,reduce harmful bacteria proliferation,effectively slow down the rate of decline in cognitive ability.In the short term,multiple well-tolerated oral health interventions reduce the economic burden associated with the disease and improve the quality of life of patients with Alzheimer’s disease.This will provide the public with an effective and low-cost way to reduce the risk of dementia in an ageing population.