Key Bacterial Taxa Differences Associated with Polypharmacy in Elderly Patients

Changes in health, lifestyle, and medication usage significantly impact overall well-being. Aging is associated with an increased need for multiple medications, or polypharmacy. Despite extensive research on how aging and polypharmacy affect the gut microbiome, relatively little is known about their impact on the oral microbiome and how shifts there can contribute to oral and systemic disease. An initial group of 55 saliva donors was formed of individuals with stage 3 periodontal disease and well-characterized for dental decay, both factors that contribute strongly to salivary microbiome identity. Relative levels of saliva bacteria were determined by 16S rRNA amplicon sequencing. Multiple variable analysis was performed to determine taxa associated with polypharmacy after correction for dental decay, tobacco use and gender. A second group, all with stage 3 periodontal disease, over 55 years of age and controlled for caries, served as a validation set. Two differences in taxa were validated as associated with polypharmacy in the elderly group. The tooth surface commensal Corynebacterium durum was lower with polypharmacy, and the dental decay-associated Propionibacterium acidifaciens was elevated. Saliva flow rate differences did not appear to be responsible for the differences seen in these taxa. Additionally, taxa associated with caries level and gender were identified. Polypharmacy associated taxa differences are potentially directly affected by medication usage, or the ailments associated with polypharmacy, and they are strong candidates to contribute to disease in the large group of elderly with poor oral health.