Abstract
Mild cognitive impairment (MCI) is a symptomatic predementia phase of the trajectory of cognitive decline, and its prevalence increases with age. Although the relationship between oral health and MCI have been explored previously, it is uncertain whether individuals with different tooth loss rates have altered MCI risks. We hereby conducted a longitudinal study by using data from the Chinese Longitudinal Healthy Longevity Survey to investigate the association. Tooth loss rate was defined as the difference of teeth between two interview waves divided by years of interval; participants were then grouped into four categories: stable, no tooth loss; mild, 0-1 tooth loss; middle, 1-2 tooth loss; and severe, more than 2 tooth loss per year. Cognitive function was assessed by the Chinese version of Mini-Mental State Examination. We used the generalized estimating equation model to estimate the odds ratio (OR) and the 95% confidence intervals (CIs) and applied the restricted cubic spline function to explore the dose-response association. Among 11,862 participants, 3,966 developed MCI in a median follow-up time of 5.93 years. Higher tooth loss rate was associated with an increased risk of MCI in elderly subjects. Compared with subjects with stable tooth, the corresponding ORs (95% CIs) were 0.94 (0.85-1.03), 1.16 (1.04-1.29) and 1.28 (1.17-1.40) for subjects with the mild, middle and severe rate of tooth loss. A nonlinear dose-response relationship was detected (Pnon-linearity = 0.0165). Similar results were observed in the subgroup analyses stratified by sex, age at baseline, and number of teeth at baseline. The positive association was only observed among denture nonwearers (OR middle vs stable: 1.19; 1.06-1.35; OR severe vs stable: 1.35; 1.22-1.50), but not among denture wearers. In conclusion, among elderly population in China, higher rate of tooth loss may be associated with an increased risk of MCI, while denture wearers may be less likely to develop MCI.
Highlights
Aging, a natural process of life, is often accompanied by various disorders or diseases including cognitive impairment [1]
We found that higher tooth loss rate was associated with an increased risk of Mild cognitive impairment (MCI) in elderly participants
The risk of MCI sharply increased in the initial stage but gradually tended to be flat with the increasing of number of tooth loss
Summary
A natural process of life, is often accompanied by various disorders or diseases including cognitive impairment [1]. Mild cognitive impairment (MCI) is the clinical stage between the expected cognitive decline of normal aging and dementia [2]. Its incidence rate widely ranges by age [3]: 22.5 per 1,000 person-years for aged 75-79, 40.9 for aged 80-84, and 60.1 for aged over 85 years [3]. In China, the incidence rate of MCI was estimated to be 70.57 per 1,000 person-years for aged over 60 years, [4] with a prevalence of 15·5%, representing 38·77 million people [5]. With huge impacts on the quality of life for patients, the global economic burden of dementia is estimated to be more than 800 billion USD [6]
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