Expression of Serum Cortisol and Aβ42 in the Prediction of Early Onset Alzheimer's Disease in Patients with Generalised Anxiety Disorders and Stage III/IV Periodontitis

Abstract

Abstract Objectives: Biochemical inflammatory mediators play a salient role in the pathogenesis as well as inflammatory responses of periodontitis initiated by microbial dysbiosis, linking chronic periodontitis to Alzheimer's disease (AD). The aim of the current study is to assess and correlate the role of serum cortisol and Aβ42 in the prediction of early onset Alzheimer's Disease in patients with and without Generalised Anxiety Disorders and Stage III/IV periodontitis. Materials and methods : 56 patients were enrolled based on the inclusion criteria into four groups with clinically healthy gingiva and Stage III/IV Periodontitis with and without generalised anxiety disorders. A full mouth periodontal examination was done and DASS-21 scores were recorded. ELISA was done to quantify the levels of serum cortisol and Aβ42. Results: Cortisol and Aβ42 levels were found to be expressed in the serum of all subjects in the four groups. The levels of assessed biomarkers were the least (Serum Cortisol: 2.57 ± 0.84, Serum Aβ42: 10.57 ± 6.49) in Group I (systemically healthy subjects with clinically healthy gingiva) and highly elevated (Serum Cortisol: 5.36 ± 3.22, Serum Aβ42: 57.64 ± 56.62) in Group IV (Generalised Anxiety Disorder with Generalised Stage III/IV Periodontitis). The clinical parameters of periodontal disease such as PI, mSBI, PPD, CAL, total number of teeth, DASS-21 depicted a significantly positive correlation with Cortisol as well as Aβ42. Conclusions: The present study suggests that a triad consisting of stress induced serum cortisol, Aβ42 along with clinical periodontal parameters could be useful predictive markers for quantifying the risk of developing Early Onset Alzheimer's Disease (EOAD).