Exploring the reciprocal relationship between cognitive function and edentulism among middle-aged and older adults in China

Objective: Previous longitudinal studies have found that cognitive function affected oral health, and vice versa. However, research is lacking on the reciprocal relationships between cognitive function and edentulism simultaneously, especially in developing countries. The present study aimed to examine the reciprocal relationship between cognitive function and edentulism among middle-aged and older adults in China. Methods: Data were derived from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study. The sample included 14,038 respondents aged 45 or older. A two-wave cross-lagged analysis was adopted to test the hypothesized model. Results: Among respondents aged 45-59, baseline cognitive function was associated with subsequent edentulism [b = -0.017, standard deviation (SD) = 0.006, P < 0.01]. In contrast, baseline edentulism was not significantly associated with poorer cognitive function at the follow-up wave (b = -0.744, SD = 0.383, P > 0.05). However, among respondents aged 60 or older, baseline cognitive function was associated with subsequent edentulism (b = -0.017, SD = 0.005, P < 0.01), and baseline edentulism was also associated with follow-up lower levels of cognitive function (b = -0.419, SD = 0.143, P < 0.01). Conclusions: These findings demonstrated the reciprocal relationships of cognitive function and edentulism. However, such relationships varied across age groups. This study demonstrates the importance of developing programs and services to promote both cognitive and oral health, especially for those in older age.