Dose-Response Meta-Analysis on Tooth Loss With the Risk of Cognitive Impairment and Dementia.

Abstract

OBJECTIVES:

To quantify the dose-response associations between tooth loss and risk of cognitive impairment and dementia.

DESIGN:

Longitudinal studies that examined the association between tooth loss and cognitive function were systematically searched on 6 databases through March 1, 2020. The study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Risk estimates were pooled using random-effects models. The dose-response associations were assessed using generalized least squares spline models.

SETTING AND PARTICIPANTS:

Adults from community, institution, outpatient or in-hospital were included in the meta-analysis.

MEASURES:

Cognitive impairment and dementia were defined by neuropsychological tests, diagnostic criteria, or medical records. Tooth loss was self-reported or assessed by clinical examinations.

RESULTS:

Fourteen studies were entered into the meta-analysis, including 34,074 participants and 4689 cases with diminished cognitive function. Participants with more tooth loss had a 1.48 times higher risk of developing cognitive impairment [95% confidence interval (CI) 1.18-1.87] and 1.28 times higher risk of being diagnosed with dementia (95% CI 1.09-1.49); however, the association was nonsignificant for participants using dentures (relative risk = 1.10, 95% CI 0.90-1.11). Eight studies were included in the dose-response analysis, and data supported the use of linear models. Each additional tooth loss was associated with a 0.014 increased relative risk of cognitive impairment and 0.011 elevated relative risks of dementia. Edentulous participants faced a 1.54 times higher risk of cognitive impairment and a 1.40 times higher risk of being diagnosed with dementia.

CONCLUSIONS AND IMPLICATIONS:

Moderate-quality evidence suggested tooth loss was independently associated with cognitive impairment and dementia; risk of diminished cognitive function increased with incremental numbers of teeth lost. Furthermore, timely prosthodontic treatment with dentures may reduce the progression of cognitive decline related to tooth loss.

• Authors: Xiang Qi, Zheng Zhu, Brenda L Plassman, Bei Wu
• Journal: Journal of the American Medical Directors Association (J Am Med Dir Assoc) Vol. 22 Issue 10 Pg. 2039-2045 (10 2021) ISSN: 1538-9375 [Electronic] United States
• PMID: 34579934 (Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Extramural, Review)
• Copyright: Copyright © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Topics

• Adult
• Cognition
• Cognitive Dysfunction (epidemiology)
• Dementia (epidemiology)
• Humans
• Tooth Loss (epidemiology)