Social participation, subjective well-being, and cognitive function as serial mediators between tooth loss and functional limitations in older Chinese adults.

Abstract

BackgroundAlthough tooth loss appears to be related to functional limitations, the mechanisms that underpin this relationship are unknown. We sought to address this knowledge gap by examining a multiple mediation hypothesis whereby tooth loss is predicted to indirectly affect functional limitations through social participation, subjective well-being, and cognitive function.MethodsThis study included 7,629 Chinese adults from the 2017/2018 Chinese Longitudinal Healthy Longevity Survey wave. The serial mediation effects were examined using Model 6 in the Hayes’ PROCESS macro for SPSS.ResultsTooth loss was significantly related to functional limitations. There was a direct (β = − 0.0308; 95% CI, − 0.0131 to − 0.0036) and indirect (β = − 0.0068; 95% CI, − 0.0096 to − 0.0041) association between tooth loss and instrumental activities of daily living (IADL) limitations, but only an indirect correlation with activities of daily living (ADL) limitations (β = − 0.0188; 95% CI, − 0.0259 to − 0.0121). Social participation, subjective well-being, and cognitive function serially mediated the relationship between tooth loss and ADL/IADL limitations.ConclusionThe association between tooth loss and functional limitations is serially mediated by social participation, subjective well-being, and cognitive function. Our findings underscore the necessity of considering psychological and social factors as integrated healthcare approaches for the functional health of older adults.