A prospective association between tooth status and cognitive performance among older adults in Europe

Abstract

Objectives This study set out to examine both the longitudinal association between tooth status and cognitive performance among older adults in Europe, and the mediating effects of loneliness and quality of life on this association. Methods We conducted a prospective analysis using data from 38,614 participants aged 50 or older, taken from the Survey of Health, Ageing and Retirement in Europe (SHARE) of 2013 (baseline) and 2015 (follow up). Bootstrapping with resampling strategies was used for testing a multiple mediator model. Results The average age of participants was 66.9 (SD = 9.4). About 23% of the participants had full sets of their own teeth and 38.2% had missing teeth fully replaced by dental implants or dentures. Participants who had partially replaced teeth (B = 0.038, p < 0.001), and with fully replaced teeth (B = 0.041, p < 0.001), or had all their teeth in place (B = 0.055, p < 0.001), had better cognitive performance compared to those who did not replace their missing teeth. It was also found that quality of life and loneliness partially mediated these relationships - Having all teeth in place or replacing all or partially missing teeth was found to affect cognitive performance also via improved quality of life and through lower loneliness. Conclusion In later life, poor tooth status can be directly associated with cognitive decline and indirectly linked to cognitive performance, in light of decreasing quality of life and increasing loneliness. Clinicians should be aware of both the impact of poor tooth status on cognitive status and the implications for the wellbeing of older adults.