Abstract
We investigated the effect of poor masticatory ability on cognitive trajectories and dementia risk in older adults. 544 cognitively intact adults aged ≥50 were followed for up to 22 years. Cognitive domains (verbal, spatial/fluid, memory, and perceptual speed) were assessed at baseline and follow-ups. Dementia was ascertained according to standard criteria. Masticatory ability was assessed using the Eichner Index and categorized according to the number of posterior occlusal zones: A (all four), B (3-1), and C (none).At baseline, 147 (27.0%) participants were in Eichner category A, 169 (31.1%) in B and 228 (41.9%) in C. After the age of 65, participants in Eichner category B and C showed an accelerated decline in spatial/fluid abilities (β: -0.16, 95% CI: -0.30 to -0.03) and (β: -0.15, 95% CI: -0.28 to -0.02), respectively. Over the follow-up, 52 incident dementia cases were identified. Eichner categories B or C were not associated with an increased risk of dementia, compared to category A (Hazard Ratio [HR]: 0.83, 95% CI: 0.39 to 1.76 and HR: 0.63, 95% CI: 0.30 to 1.29, respectively).Poor masticatory ability is associated with an accelerated cognitive decline in fluid/spatial abilities, however it was not related to a higher risk of dementia.
Highlights
The global population is growing older and one consequence of this is an increase in the prevalence of dementia, which is the greatest global challenge for health and social care [1]
Eichner categories B or C were not associated with an increased risk of dementia, compared to category A (Hazard Ratio [hazard ratios (HRs)]: 0.83, 95% confidence intervals (CIs): 0.39 to 1.76 and HR: 0.63, 95% CI: 0.30 to 1.29, respectively)
In this population–based longitudinal study with up to 22 years of follow-up, we found that having less posterior occlusal support, a marker of poorer masticatory ability, was related to the level of verbal ability and faster rate of decline in spatial/fluid abilities after the age of 65
Summary
The global population is growing older and one consequence of this is an increase in the prevalence of dementia, which is the greatest global challenge for health and social care [1]. Older people are at a high risk of oral problems (such as periodontal disease, orofacial pain and the loss of teeth) [2]. Several studies have shown that tooth loss is associated with steeper global cognitive decline [4, 5], an increased risk for cognitive impairment [6,7,8] and dementia [9], as well as brain atrophy in cognitively normal older individuals [10]. Emerging evidence suggests that the mechanism behind the association between tooth loss and cognitive decline is linked to reduced mechanical sensory input from poor mastication resulting from the loss of teeth [4, 10]
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