Longitudinal Association Between Oral Status and Cognitive Decline Using Fixed-effects Analysis
Open Access
- 5 July 2022
- journal article
- research article
- Published by Japan Epidemiological Association in Journal of Epidemiology
- Vol. 32 (7), 330-336
- https://doi.org/10.2188/jea.je20200476
Abstract
Background Although the feasibility of randomized trials for investigating the long-term association between oral health and cognitive decline is low, deriving causal inferences from observational data is challenging. We aimed to investigate the association between poor oral status and subjective cognitive complaints (SCC) using fixed-effects model to eliminate the confounding effect of unobserved time-invariant factors. Methods We used data from Japan Gerontological Evaluation Study (JAGES) which was conducted in 2010, 2013, and 2016. β regression coefficients (95% confidence intervals) were calculated using fixed-effects models to determine the effect of deteriorating oral status on developing SCC. Onset of SCC was evaluated using the Kihon Checklist-Cognitive function score. Four oral status variables were used: awareness of swallowing difficulty, decline in masticatory function, dry mouth, and number of teeth. Results 13,594 participants (55.8% women) without SCC at baseline were included. The mean age was 72.4 (SD = 5.1) for men and 72.4 (SD=4.9) for women. Within the 6-year follow-up, 26.6% of men and 24.9% of women developed SCC. The probability of developing SCC was significantly higher when participants acquired swallowing difficulty (β= 0.088; 0.065-0.111 for men, β= 0.077; 0.057-0.097 for women), decline in masticatory function (β=0.039; 0.021-0.057 for men, β= 0.030; 0.013-0.046 for women), dry mouth (β= 0.026; 0.005-0.048 for men, β= 0.064; 0.045-0.083 for women), and tooth loss (β= 0.043; 0.001-0.085 for men, β= 0.058; 0.015-0.102 for women). Conclusions The findings suggest that good oral health needs to be maintained to prevent the development of SCC, which increases the risk for future dementia.Keywords
This publication has 48 references indexed in Scilit:
- Nutritional Biomarkers and Subsequent Cognitive Decline Among Community-Dwelling Older Japanese: A Prospective StudyThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2014
- Fixed effects analysis of repeated measures dataInternational Journal of Epidemiology, 2013
- Association between functional tooth units and chewing ability in older adults: a systematic reviewGerodontology, 2012
- Dysphagia in the elderly: management and nutritional considerationsClinical Interventions in Aging, 2012
- Association Between Self-Reported Dental Health Status and Onset of DementiaPsychosomatic Medicine, 2012
- MissForest—non-parametric missing value imputation for mixed-type dataBioinformatics, 2011
- Oral Health-Related Quality of Life among a large national cohort of 87,134 Thai adultsHealth and Quality of Life Outcomes, 2011
- Mild Cognitive ImpairmentThe New England Journal of Medicine, 2011
- Reasons for Permanent Tooth Extractions in JapanJournal of Epidemiology, 2006
- Development of a Visual Analogue Scale questionnaire for subjective assessment of salivary dysfunctionOral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2001