TY - JOUR
T1 - Oral Status and Dementia Onset
T2 - Mediation of Nutritional and Social Factors
AU - Kiuchi, S.
AU - Cooray, U.
AU - Kusama, T.
AU - Yamamoto, T.
AU - Abbas, H.
AU - Nakazawa, N.
AU - Kondo, K.
AU - Osaka, K.
AU - Aida, J.
N1 - Funding Information:
The author/authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study used data from JAGES (Japan Gerontological Evaluation Study). This study was supported by Grant-in-Aid for Scientific Research from JSPS (Japan Society for the Promotion of Science) KAKENHI Grant Number (JP15H01972, JP 16H05556, JP19H03860, JP19H03861, 20H00557, 19H03860); Health Labour Sciences Research Grant (H28-Choju-Ippan-002, H30-Jyunkankinado-Ippan-004, 19FA1012, 21FA1013); Japan Agency for Medical Research and Development (AMED) (JP17dk0110017, JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP20dk0110037, 21lk0310073h0002); Open Innovation Platform with Enterprises, Research Institute and Academia (OPERA, JPMJOP1831) from the Japan Science and Technology (JST); a grant from Innovative Research Program on Suicide Countermeasures (1-4); a grant from Sasakawa Sports Foundation; a grant from Japan Health Promotion & Fitness Foundation; a grant from Chiba Foundation for Health Promotion & Disease Prevention; the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation (adopted number: 19-2-06); a grant from Niimi University (1915010); grants from Meiji Yasuda Life Foundation of Health and Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology (29-42, 30-22, 20-19); and the Health Care Science Institute Research Grant.
Funding Information:
The author/authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study used data from JAGES (Japan Gerontological Evaluation Study). This study was supported by Grant-in-Aid for Scientific Research from JSPS (Japan Society for the Promotion of Science) KAKENHI Grant Number (JP15H01972, JP 16H05556, JP19H03860, JP19H03861, 20H00557, 19H03860); Health Labour Sciences Research Grant (H28-Choju-Ippan-002, H30-Jyunkankinado-Ippan-004, 19FA1012, 21FA1013); Japan Agency for Medical Research and Development (AMED) (JP17dk0110017, JP18dk0110027, JP18ls0110002, JP18le0110009, JP20dk0110034, JP20dk0110037, 21lk0310073h0002); Open Innovation Platform with Enterprises, Research Institute and Academia (OPERA, JPMJOP1831) from the Japan Science and Technology (JST); a grant from Innovative Research Program on Suicide Countermeasures (1-4); a grant from Sasakawa Sports Foundation; a grant from Japan Health Promotion & Fitness Foundation; a grant from Chiba Foundation for Health Promotion & Disease Prevention; the 8020 Research Grant for fiscal 2019 from the 8020 Promotion Foundation (adopted number: 19-2-06); a grant from Niimi University (1915010); grants from Meiji Yasuda Life Foundation of Health and Welfare and the Research Funding for Longevity Sciences from National Center for Geriatrics and Gerontology (29-42, 30-22, 20-19); and the Health Care Science Institute Research Grant.
Publisher Copyright:
© International Association for Dental Research and American Association for Dental, Oral, and Craniofacial Research 2021.
PY - 2022/4
Y1 - 2022/4
N2 - Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson–Holm–Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01–1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98–1.25), leaving an indirect effect of 1.03 (95% CI, 1.02–1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.
AB - Some modifiable risk factors for dementia are closely related to oral health. Although eating and speaking abilities are fundamental oral functions, limited studies have focused on the effect of malnutrition and lack of social interaction between oral health and dementia. We investigated the mediating effects of nutritional and social factors on the association between the number of teeth and the incidence of dementia. This 6-y cohort study used data from the Japan Gerontological Evaluation Study targeting older adults aged 65 y and above. The number of teeth (exposure) and covariates in 2010 (baseline survey), mediators (weight loss, vegetable and fruit intake, homeboundness, social network) in 2013, and the onset of dementia (outcome) between 2013 and 2016 were obtained. The Karlson–Holm–Breen mediation method was applied. A total of 35,744 participants were included (54.0% women). The mean age at baseline was 73.1 ± 5.5 y for men and 73.2 ± 5.5 y for women. A total of 1,776 participants (5.0%) had dementia during the follow-up period. There was a significant total effect of the number of teeth on the onset of dementia (hazard ratio, 1.14; 95% CI, 1.01–1.28). Controlling for nutritional and social mediators, the effect of the number of teeth was reduced to 1.10 (95% CI, 0.98–1.25), leaving an indirect effect of 1.03 (95% CI, 1.02–1.04). In the sex-stratified analysis, the proportion mediated by weight loss was 6.35% for men and 4.07% for women. The proportions mediated by vegetable and fruit intake and homeboundness were 4.44% and 4.83% for men and 8.45% and 0.93% for women, respectively. Furthermore, the proportion mediated by social networks was 13.79% for men and 4.00% for women. Tooth loss was associated with the onset of dementia. Nutritional and social factors partially mediated this association.
KW - cohort studies
KW - dental public health
KW - epidemiology
KW - gerontology
KW - nutrition/nutritional sciences
KW - psychosocial factors
UR - http://www.scopus.com/inward/record.url?scp=85119659324&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85119659324&partnerID=8YFLogxK
U2 - 10.1177/00220345211049399
DO - 10.1177/00220345211049399
M3 - Article
C2 - 34796750
AN - SCOPUS:85119659324
VL - 101
SP - 420
EP - 427
JO - Journal of Dental Research
JF - Journal of Dental Research
SN - 0022-0345
IS - 4
ER -