The impact of periodontal disease on cognition: an oral microbiome perspective
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Mathur, Rohan
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Abstract
Periodontal disease, a chronic inflammatory condition affecting nearly half of U.S. adults, has traditionally been viewed through the lens of oral health. However, mounting evidence suggests its relevance extends well beyond the mouth, implicating oral microbiome dysbiosis in systemic and neurodegenerative conditions, including Alzheimer’s disease. This thesis investigates the link between oral health and cognitive function through the lens of the oral microbiome. Specifically, it explores whether pre-existing clinical microbiome data can be paired with remote cognitive testing to identify early cognitive vulnerabilities, particularly in executive function and memory.
This cross-sectional pilot study leveraged clinical microbiome records from a dental office and administered six web-based cognitive tasks through Testable, assessing domains commonly affected in neurodegenerative progression. These included measures of impulse control, attention, cognitive flexibility, reasoning, and recognition memory. A specific focus was placed on executive functioning and memory as these two domains are frequently impacted in early neurodegenerative decline. Despite rigorous design and ethical compliance, enrollment challenges limited data collection to a single participant.
While statistical inference was not possible, the case study demonstrated a feasible pipeline for integrating clinical oral profiles with remote neurocognitive assessments. Notably, the participant’s profile aligned with prior literature. Elevated levels of Treponema denticola and Tannerella forsythia co-occurred with reduced performance on tasks assessing inhibition and cognitive flexibility, but preserved memory function.
This thesis also identifies practical barriers to enrollment and proposes targeted improvements, including in-office consent, shorter cognitive batteries, and broadened recruitment efforts. Ultimately, while preliminary, this research supports the emerging view that oral microbial profiles may offer non-invasive biomarkers for cognitive risk, with implications for early detection and intervention. By demonstrating the feasibility of merging clinical oral profiles with remote neurocognitive testing, this research lays critical groundwork for a scalable, preventative approach to cognitive health rooted in routine dental care.
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Undergraduate Research Option Thesis