Association Between Tooth Loss and Cognitive Function Among 3063 Chinese Older Adults: a Community-based Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2015 Mar 25

PMID 25803052

Citations 41

Authors

Jianfeng Luo

Bei Wu

Qianhua Zhao

Qihao Guo

Haijiao Meng

Lirong Yu

Li Zheng

Zhen Hong

Ding Ding

Affiliations

Soon will be listed here.

Abstract

Background: Oral health has been found to be associated with cognitive function in basic research and epidemiology studies. Most of these studies had no comprehensive clinical diagnosis on cognitive function. This study firstly reported the association between tooth loss and cognitive function among Chinese older population.

Methods: The study included 3,063 community dwelling older adults aged 60 or above from the Shanghai Aging Study. Number of teeth missing was obtained from self-reporting questionnaire and confirmed by trained interviewers. Participants were diagnosed as "dementia", "mild cognitive impairment (MCI)", or "cognitive normal" by neurologists using DSM-IV and Petersen criteria. Multivariate logistic regression model was applied to examine the association between number of teeth missing and cognitive function.

Results: The study participants had an average of 10.2 teeth lost. Individuals with dementia lost 18.7 teeth on average, much higher than those with MCI (11.8) and cognitive normal (9.3) (p<0.001). After adjusted for sex, age, education year, living alone, body mass index, cigarette smoking, alcohol drinking, anxiety, depression, heart disease, hypertension, diabetes, and APOE-ε4, tooth loss of >16 were significantly associated with dementia with an OR of 1.56 (95%CI 1.12-2.18).

Conclusion: Having over 16 missing teeth was associated with severe cognitive impairment among Chinese older adults. Poor oral health might be considered as a related factor of neurodegenerative symptom among older Chinese population.

Citing Articles

The association between oral health and mild cognitive impairment in community-dwelling older adults.

Ye N, Deng B, Hu H, Ai Y, Liu X, Zhou S Front Public Health. 2024; 12:1464439.

PMID: 39484361 PMC: 11524816. DOI: 10.3389/fpubh.2024.1464439.

Tooth Loss in Periodontitis Patients-A Risk Factor for Mild Cognitive Impairment: A Systematic Review and Meta-Analysis.

Agarwal B, Bizzoca M, Musella G, De Vito D, Lo Muzio L, Ballini A J Pers Med. 2024; 14(9).

PMID: 39338207 PMC: 11433130. DOI: 10.3390/jpm14090953.

Correlation study of periodontitis with cognitive impairment.

Tao Y, He M, Hu H, Gao Z, Huang Z, Li H Hua Xi Kou Qiang Yi Xue Za Zhi. 2024; 40(5):549-553.

PMID: 38596975 PMC: 9588862. DOI: 10.7518/hxkq.2022.05.007.

Associations of oral health status and swallowing function with cognitive impairment in the aging population: a cross-sectional study.

Chen Y, Li C, Fan Y, Jiao L, Silverman M, Ishimaru M BMC Oral Health. 2023; 23(1):912.

PMID: 37993856 PMC: 10666324. DOI: 10.1186/s12903-023-03640-5.

Importance of oral health in mental health disorders: An updated review.

Skallevold H, Rokaya N, Wongsirichat N, Rokaya D J Oral Biol Craniofac Res. 2023; 13(5):544-552.

PMID: 37396968 PMC: 10314291. DOI: 10.1016/j.jobcr.2023.06.003.

References

Wu B, Plassman B, Liang J, Wei L . Cognitive function and dental care utilization among community-dwelling older adults. Am J Public Health. 2007; 97(12):2216-21. PMC: 2089110. DOI: 10.2105/AJPH.2007.109934. View

Krall Kaye E, Valencia A, Baba N, Spiro 3rd A, Dietrich T, Garcia R . Tooth loss and periodontal disease predict poor cognitive function in older men. J Am Geriatr Soc. 2010; 58(4):713-8. PMC: 3649065. DOI: 10.1111/j.1532-5415.2010.02788.x. View

Pitiphat W, Garcia R, Douglass C, Joshipura K . Validation of self-reported oral health measures. J Public Health Dent. 2002; 62(2):122-8. DOI: 10.1111/j.1752-7325.2002.tb03432.x. View

Lexomboon D, Trulsson M, Wardh I, Parker M . Chewing ability and tooth loss: association with cognitive impairment in an elderly population study. J Am Geriatr Soc. 2012; 60(10):1951-6. DOI: 10.1111/j.1532-5415.2012.04154.x. View

Douglass C, Berlin J, Tennstedt S . The validity of self-reported oral health status in the elderly. J Public Health Dent. 1991; 51(4):220-2. DOI: 10.1111/j.1752-7325.1991.tb02218.x. View

Kim J, Stewart R, Prince M, Kim S, Yang S, Shin I . Dental health, nutritional status and recent-onset dementia in a Korean community population. Int J Geriatr Psychiatry. 2007; 22(9):850-5. DOI: 10.1002/gps.1750. View

Tucker K, Qiao N, Scott T, Rosenberg I, Spiro 3rd A . High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study. Am J Clin Nutr. 2005; 82(3):627-35. DOI: 10.1093/ajcn.82.3.627. View

Ebersole J . Systemic humoral immune responses in periodontal disease. Crit Rev Oral Biol Med. 1990; 1(4):283-331. DOI: 10.1177/10454411900010040601. View

Stewart R, Weyant R, Garcia M, Harris T, Launer L, Satterfield S . Adverse oral health and cognitive decline: the health, aging and body composition study. J Am Geriatr Soc. 2013; 61(2):177-84. PMC: 3578234. DOI: 10.1111/jgs.12094. View

10.

Batty G, Li Q, Huxley R, Zoungas S, Taylor B, Neal B . Oral disease in relation to future risk of dementia and cognitive decline: prospective cohort study based on the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified-Release Controlled Evaluation (ADVANCE) trial. Eur Psychiatry. 2011; 28(1):49-52. PMC: 4170753. DOI: 10.1016/j.eurpsy.2011.07.005. View

11.

Stein P, Desrosiers M, Donegan S, Yepes J, Kryscio R . Tooth loss, dementia and neuropathology in the Nun study. J Am Dent Assoc. 2007; 138(10):1314-22. DOI: 10.14219/jada.archive.2007.0046. View

12.

Gatz M, Mortimer J, Fratiglioni L, Johansson B, Berg S, Reynolds C . Potentially modifiable risk factors for dementia in identical twins. Alzheimers Dement. 2009; 2(2):110-7. DOI: 10.1016/j.jalz.2006.01.002. View

13.

Ebersole J, Machen R, Steffen M, Willmann D . Systemic acute-phase reactants, C-reactive protein and haptoglobin, in adult periodontitis. Clin Exp Immunol. 1997; 107(2):347-52. PMC: 1904587. DOI: 10.1111/j.1365-2249.1997.270-ce1162.x. View

14.

SAXE S, Wekstein M, Kryscio R, Henry R, Cornett C, Snowdon D . Alzheimer's disease, dental amalgam and mercury. J Am Dent Assoc. 1999; 130(2):191-9. DOI: 10.14219/jada.archive.1999.0168. View

15.

Riviere G, Riviere K, Smith K . Molecular and immunological evidence of oral Treponema in the human brain and their association with Alzheimer's disease. Oral Microbiol Immunol. 2002; 17(2):113-8. DOI: 10.1046/j.0902-0055.2001.00100.x. View

16.

Wu B . Dental service utilization among urban and rural older adults in China -- a brief communication. J Public Health Dent. 2007; 67(3):185-8. DOI: 10.1111/j.1752-7325.2007.00038.x. View

17.

Zhang Z, Zahner G, Roman G, Liu J, Hong Z, Qu Q . Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu. Arch Neurol. 2005; 62(3):447-53. DOI: 10.1001/archneur.62.3.447. View

18.

Hibberd C, Nguyen T . Brain abscess secondary to a dental infection in an 11-year-old child: case report. J Can Dent Assoc. 2012; 78:c49. View

19.

Andrews M, Farnham S . Brain abscess secondary to dental infection. Gen Dent. 1990; 38(3):224-5. View

20.

Noack B, Genco R, Trevisan M, Grossi S, Zambon J, De Nardin E . Periodontal infections contribute to elevated systemic C-reactive protein level. J Periodontol. 2001; 72(9):1221-7. DOI: 10.1902/jop.2000.72.9.1221. View