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Review
. 2025 Apr 25:18:2119-2136.
doi: 10.2147/IDR.S491628. eCollection 2025.

Association Between Porphyromonas gingivalis and Alzheimer's Disease: A Comprehensive Review

Jéssica María Sarmiento-Ordóñez  1   2 , Dayvid Rafael Brito-Samaniego  3 , Ana Cristina Vásquez-Palacios  1 , Edisson-Mauricio Pacheco-Quito  1   2
Affiliations
Review

Association Between Porphyromonas gingivalis and Alzheimer's Disease: A Comprehensive Review

Jéssica María Sarmiento-Ordóñez et al. Infect Drug Resist. .

Abstract

Background: Periodontitis has long been linked to various inflammatory, chronic, and immunological diseases, such as heart disease or diabetes. Recently, there has been increasing scientific interest in the bidirectional relationship that may exist between periodontitis and the presence and progression of Alzheimer's disease (AD), where it is hypothesized that the infiltration of oral microorganisms (mainly Porphyromonas gingivalis) into the bloodstream, which subsequently reaches the brain, causes inflammatory and neurodegenerative processes related to AD.

Purpose: The purpose of this review is to determine the association between Porphyromonas gingivalis and Alzheimer's disease in older adults.

Patients and methods: It was carried out using different databases such as PubMed, Web of Science, among others, of no more than 10 years old focused on older adult patients who have presented periodontitis and Alzheimer's disease. MESH-indexed terms were used, getting 307 articles. After removing 206 duplicates and applying inclusion criteria (language, relevance, and contribution to the study's objectives), 24 articles were selected for analysis.

Conclusion: Evidence has been found that gingipains produced by P. gingivalis may contribute to the formation of amyloid plaques in the brain and nerve cell damage characteristic of Alzheimer's disease. It has also been observed that P. gingivalis can enter the brain and stimulate a local immune response. Although the association is promising, more research is needed to confirm it and to develop effective treatments. These findings may have significant implications for clinical practice, potentially leading to preventive or therapeutic strategies targeting oral health as a modifiable risk factor for AD. Further research could focus on exploring these pathways and developing targeted interventions.

Keywords: Alzheimer’s disease; Porphyromonas gingivalis; older adults; periodontitis.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Representation of the pathophysiology of Alzheimer’s disease.
Figure 2
Figure 2
Representation of the way in which P. gingivalis and its toxins can migrate extra orally.
Figure 3
Figure 3
Process by which P. gingivalis and gingipains can induce the appearance and development of Alzheimer’s disease.
See this image and copyright information in PMC

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