Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population

Abstract Objective Our study aimed to investigate the relationship between the number of teeth remaining and cognitive impairment among Chinese older adults, and to explore the role of low body weight in this association. Methods Data were drawn from 2011 to 2014 surveys of the Chinese Longitudinal...

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Main Authors: Pan Ke, Zuxun Lu, Wenqing Ni, Yan Zhang, Hongmin Zhang, Yijin Zheng, Xueli Yuan, Jian Xu, Xiaoxv Yin, Zhiguang Zhao
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Geriatrics
Subjects:
Online Access:https://doi.org/10.1186/s12877-025-05750-x
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author Pan Ke
Zuxun Lu
Wenqing Ni
Yan Zhang
Hongmin Zhang
Yijin Zheng
Xueli Yuan
Jian Xu
Xiaoxv Yin
Zhiguang Zhao
author_facet Pan Ke
Zuxun Lu
Wenqing Ni
Yan Zhang
Hongmin Zhang
Yijin Zheng
Xueli Yuan
Jian Xu
Xiaoxv Yin
Zhiguang Zhao
author_sort Pan Ke
collection DOAJ
description Abstract Objective Our study aimed to investigate the relationship between the number of teeth remaining and cognitive impairment among Chinese older adults, and to explore the role of low body weight in this association. Methods Data were drawn from 2011 to 2014 surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), involving 4056 respondents who had no cognitive decline and aged ≥ 65 years at baseline. Cognitive function was measured by the Mini-Mental Status Examination (MMSE), and the cognitive impairment was classified according to the length of education. Number of natural teeth was self-reported (classified as ≥ 20, 10–19, 1–9, and 0). Low body weight was defined as having a body mass index (BMI) of less than 18.5 kg/m2. Cox proportional hazards regression and mediation effect analyses were applied in the study. Results Comparing with participants with ≥ 20 teeth, 10–19 teeth and 1–9 teeth, those with 0 teeth (HR:2.14, 95% CI: 1.51, 3.03) were significantly associated with higher cognitive impairment risk in the fully adjusted model. Compared with denture users, the fully adjusted HR (95% CI) for non-denture users was 1.33 (1.04, 1.70). no teeth with non-denture users had the highest cognitive impairment risk (HR:1.63, 95% CI: 1.10, 2.41). Low body weight mediated 6.74% (ranging from 3.49 to 11%) of the association between the number of teeth remaining and cognitive impairment. Conclusion Tooth loss increases the risk of cognitive decline, and low body weight partially mediates this association. Clinical trial number This is a retrospective cohort study targeting a population survey, which does not involve clinical trials and does not have clinical trial numbers.
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spelling doaj-art-4361a6ee95d94df4a8375e87e0003ba02025-08-20T02:15:01ZengBMCBMC Geriatrics1471-23182025-02-012511910.1186/s12877-025-05750-xDoes low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese populationPan Ke0Zuxun Lu1Wenqing Ni2Yan Zhang3Hongmin Zhang4Yijin Zheng5Xueli Yuan6Jian Xu7Xiaoxv Yin8Zhiguang Zhao9Cardio-Cerebrovascular & Diabetes Prevention, and Control Dept., Shenzhen Center for Chronic Disease ControlDepartment of Social Medicine and Health Management, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Elderly Health Management, Shenzhen Center for Chronic Disease ControlDepartment of Elderly Health Management, Shenzhen Center for Chronic Disease ControlDepartment of Elderly Health Management, Shenzhen Center for Chronic Disease ControlDepartment of Elderly Health Management, Shenzhen Center for Chronic Disease ControlDepartment of Elderly Health Management, Shenzhen Center for Chronic Disease ControlDepartment of Elderly Health Management, Shenzhen Center for Chronic Disease ControlDepartment of Social Medicine and Health Management, Tongji Medical College, Huazhong University of Science and TechnologyCardio-Cerebrovascular & Diabetes Prevention, and Control Dept., Shenzhen Center for Chronic Disease ControlAbstract Objective Our study aimed to investigate the relationship between the number of teeth remaining and cognitive impairment among Chinese older adults, and to explore the role of low body weight in this association. Methods Data were drawn from 2011 to 2014 surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), involving 4056 respondents who had no cognitive decline and aged ≥ 65 years at baseline. Cognitive function was measured by the Mini-Mental Status Examination (MMSE), and the cognitive impairment was classified according to the length of education. Number of natural teeth was self-reported (classified as ≥ 20, 10–19, 1–9, and 0). Low body weight was defined as having a body mass index (BMI) of less than 18.5 kg/m2. Cox proportional hazards regression and mediation effect analyses were applied in the study. Results Comparing with participants with ≥ 20 teeth, 10–19 teeth and 1–9 teeth, those with 0 teeth (HR:2.14, 95% CI: 1.51, 3.03) were significantly associated with higher cognitive impairment risk in the fully adjusted model. Compared with denture users, the fully adjusted HR (95% CI) for non-denture users was 1.33 (1.04, 1.70). no teeth with non-denture users had the highest cognitive impairment risk (HR:1.63, 95% CI: 1.10, 2.41). Low body weight mediated 6.74% (ranging from 3.49 to 11%) of the association between the number of teeth remaining and cognitive impairment. Conclusion Tooth loss increases the risk of cognitive decline, and low body weight partially mediates this association. Clinical trial number This is a retrospective cohort study targeting a population survey, which does not involve clinical trials and does not have clinical trial numbers.https://doi.org/10.1186/s12877-025-05750-xCognitive impairmentTooth lossDenture useLow body weightOlder adults
spellingShingle Pan Ke
Zuxun Lu
Wenqing Ni
Yan Zhang
Hongmin Zhang
Yijin Zheng
Xueli Yuan
Jian Xu
Xiaoxv Yin
Zhiguang Zhao
Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population
BMC Geriatrics
Cognitive impairment
Tooth loss
Denture use
Low body weight
Older adults
title Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population
title_full Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population
title_fullStr Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population
title_full_unstemmed Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population
title_short Does low body weight mediate the relationship between tooth loss and cognitive impairment? A longitudinal cohort study of an older Chinese population
title_sort does low body weight mediate the relationship between tooth loss and cognitive impairment a longitudinal cohort study of an older chinese population
topic Cognitive impairment
Tooth loss
Denture use
Low body weight
Older adults
url https://doi.org/10.1186/s12877-025-05750-x
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