Luo Jianfeng, Wu Bei, Zhao Qianhua, Guo Qihao, Meng Haijiao, Yu Lirong, Zheng Li, Hong Zhen, Ding Ding
Department of Health Statistics and Social Medicine, School of Public Health, Fudan University, The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Institute of Neurology, Huashan Hospital, Fudan University, WHO Collaborating Center for Research and Training in Neurosciences, Shanghai, China.
School of Nursing and Global Health Institute, Duke University, Durham, North Carolina, United States of America; School of Sociology and Political Sciences, Shanghai University, Shanghai, China.
PLoS One. 2015 Mar 24;10(3):e0120986. doi: 10.1371/journal.pone.0120986. eCollection 2015.
Oral health has been found to be associated with cognitive function in basic research and epidemiology studies. Most of these studies had no comprehensive clinical diagnosis on cognitive function. This study firstly reported the association between tooth loss and cognitive function among Chinese older population.
The study included 3,063 community dwelling older adults aged 60 or above from the Shanghai Aging Study. Number of teeth missing was obtained from self-reporting questionnaire and confirmed by trained interviewers. Participants were diagnosed as "dementia", "mild cognitive impairment (MCI)", or "cognitive normal" by neurologists using DSM-IV and Petersen criteria. Multivariate logistic regression model was applied to examine the association between number of teeth missing and cognitive function.
The study participants had an average of 10.2 teeth lost. Individuals with dementia lost 18.7 teeth on average, much higher than those with MCI (11.8) and cognitive normal (9.3) (p<0.001). After adjusted for sex, age, education year, living alone, body mass index, cigarette smoking, alcohol drinking, anxiety, depression, heart disease, hypertension, diabetes, and APOE-ε4, tooth loss of >16 were significantly associated with dementia with an OR of 1.56 (95%CI 1.12-2.18).
Having over 16 missing teeth was associated with severe cognitive impairment among Chinese older adults. Poor oral health might be considered as a related factor of neurodegenerative symptom among older Chinese population.
在基础研究和流行病学研究中，已发现口腔健康与认知功能有关。这些研究大多未对认知功能进行全面的临床诊断。本研究首次报告了中国老年人群中牙齿缺失与认知功能之间的关联。
该研究纳入了来自上海老龄化研究的3063名60岁及以上的社区居住老年人。牙齿缺失数量通过自我报告问卷获得，并由经过培训的访谈员进行确认。神经科医生使用DSM-IV和彼得森标准将参与者诊断为“痴呆症”、“轻度认知障碍（MCI）”或“认知正常”。应用多变量逻辑回归模型来检验牙齿缺失数量与认知功能之间的关联。
研究参与者平均缺失10.2颗牙齿。痴呆症患者平均缺失18.7颗牙齿，远高于MCI患者（11.8颗）和认知正常者（9.3颗）（p<0.001）。在对性别、年龄、受教育年限、独居、体重指数、吸烟、饮酒、焦虑、抑郁、心脏病、高血压、糖尿病和APOE-ε4进行调整后，牙齿缺失超过16颗与痴呆症显著相关，比值比为1.56（95%置信区间1.12-2.18）。
在中国老年人中，牙齿缺失超过16颗与严重认知障碍有关。口腔健康状况不佳可能被视为中国老年人群神经退行性症状的一个相关因素。
