Tooth Loss Associated with Physical and Cognitive Decline in Older Adults

ObjectivesTo examine the effect of total tooth loss (edentulousness) on decline in physical and cognitive functioning over 10years in older adults in England. DesignSecondary data analysis. SettingEnglish Longitudinal Study of Ageing, a national prospective cohort study of community-dwelling people aged 50 and older. ParticipantsIndividuals aged 60 and older (N=3,166). MeasurementsCognitive function (memory) was measured using a 10-word recall test. Physical function was assessed using gait speed (m/s). Generalized estimating equations were used to model associations between baseline edentulousness and six repeated measurements of gait speed and memory from 2002-03 to 2012-13. Models were sequentially adjusted for time, demographic characteristics, socioeconomic status, comorbidities, health behaviors, depressive symptoms, and anthropometric measurements and mutually adjusted for gait speed or memory. ResultsEdentulous participants recalled 0.88 fewer words and were 0.09m/s slower than dentate participants after adjusting for time and demographics. Only the latter association remained significant after full adjustment, with edentulous participants being 0.02m/s slower than dentate participants. In age-stratified analyses, baseline edentulousness was associated with both outcomes in fully adjusted models in participants aged 60 to 74 but not in those aged 75 and older. Supplementary analysis indicated significant associations between baseline edentulousness and 4-year change in gait speed and memory in participants aged 60 to 74; the former was fully explained in the fully adjusted model and the latter after adjusting for socioeconomic status. ConclusionTotal tooth loss was independently associated with physical and cognitive decline in older adults in England. Tooth loss is a potential early marker of decline in older age.