Association between Tooth Loss and Cognitive Function among 3063 Chinese Older Adults: A Community-Based Study

Abstract

BackgroundOral 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.MethodsThe 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.ResultsThe 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).ConclusionHaving 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.

Home-based oral healthcare strategies of elderly people with Alzheimer's disease

“…[8][9][10][11] They indicate issues such as the loss of capacity of elderly persons with AD to eat alone, relating this loss to the fact that they also fail to perform their dental hygiene 10 . Caregivers should be attentive to this issue, as the fact that the elderly person has lost the ability to feed himself or herself can be an indication of the loss of other capabilities, such as the ability to perform oral care.…”

“…[4][5][6] Other studies have described a high prevalence of dental caries in individuals in advanced stages of AD, 7 and found an association between the presence of dental caries in elderly persons in the initial stage of AD and a high risk of root caries. [8][9][10]12 Issues relating to the state of oral health of elderly persons with AD and the way in which oral care is provided to these patients have been considered in a number of studies. 9 Elderly persons that no longer have the capacity to feed themselves alone are in the majority of cases also unable to carry out oral health tasks.…”

“…10 Ideally, oral health tasks are carried out by the caregiver, as it is difficult for dementia sufferers to perform these activities. 8 In such cases, caregivers are the main providers of care for these patients, and therefore the planning of oral care should consider the perception of these caregivers and their knowledge of oral health and hygene. 8 Furthermore, according to some authors, oral health should be reinforced by focusing on the caregivers of elderly persons with AD, so that they can provide, in addition to daily oral health activities that maintain health and well-being, care aimed at the specific oral health care needs of elderly persons.…”

“…8 In such cases, caregivers are the main providers of care for these patients, and therefore the planning of oral care should consider the perception of these caregivers and their knowledge of oral health and hygene. 8 Furthermore, according to some authors, oral health should be reinforced by focusing on the caregivers of elderly persons with AD, so that they can provide, in addition to daily oral health activities that maintain health and well-being, care aimed at the specific oral health care needs of elderly persons. 9,11 In this context, it is important to identify the oral health strategies used by caregivers of elderly persons with AD, provided in the home, and to consider if these strategies differ according to the phase of the disease.…”

The Relationship Between Oral Health and Cognitive Status of the Elderly

“…The reaction of the immune system to oral and dental bacteria seems resulted in the death of nerve cells or attenuation of memory (6,7). According to some studies, reduced number of teeth is associated with increased incidence of cognitive decline (5,8). These researchers recommended further studies in this field.…”