Li Juan, Xu Hanzhang, Pan Wei, Wu Bei
Nursing School of Second Military Medical University, Shanghai, China.
Duke University School of Nursing, Durham, United States of America.
PLoS One. 2017 Feb 3;12(2):e0171404. doi: 10.1371/journal.pone.0171404. eCollection 2017.
To examine the association between the number of teeth remaining and cognitive decline among Chinese older adults over a 13-year period.
A large national longitudinal survey of Chinese older adults.
The Chinese Longitudinal Healthy Longevity Survey (CLHLS) (1998-2011).
A total of 8,153 eligible participants aged 60+ interviewed in up to six waves.
Cognitive function and teeth number were measured at each interview. Cognitive function was measured by the Mini-Mental Status Examination (MMSE). Number of natural teeth was self-reported. Individuals with severe cognitive impairment were excluded. Covariates included demographic characteristics, adult socioeconomic status characteristics, childhood socioeconomic status, health conditions, and health behaviors. Linear mixed models were applied in the analysis.
The mean teeth number at baseline was 17.5(SD = 0.1), and the mean of baseline cognitive function was 27.3(SD = 0.0). Cognitive function declined over time (β = -0.19, P < .001) after controlling covariates. But, regardless of time, more teeth were associated with better cognitive function (β = 0.01, P < .001). The interaction of teeth number and time was significant (β = 0.01, P < .001), suggesting that the participants who had more teeth showed a slower pace of cognitive decline over time than those with fewer teeth after controlling for other covariates.
This study showed that tooth loss was associated with cognitive decline among Chinese older adults. Further studies are needed to examine the linkages between cognitive decline and oral health status using clinical examination data.
研究13年间中国老年人剩余牙齿数量与认知功能衰退之间的关联。
对中国老年人进行的一项大型全国纵向调查。
中国健康与养老追踪调查（CLHLS）（1998 - 2011年）。
共有8153名符合条件的60岁及以上参与者，接受了多达六轮访谈。
每次访谈时测量认知功能和牙齿数量。认知功能通过简易精神状态检查表（MMSE）进行测量。自然牙数量由参与者自我报告。排除患有严重认知障碍的个体。协变量包括人口统计学特征、成人社会经济地位特征、儿童时期社会经济地位、健康状况和健康行为。分析采用线性混合模型。
基线时平均牙齿数量为17.5（标准差 = 0.1），基线认知功能平均分为27.3（标准差 = 0.0）。在控制协变量后，认知功能随时间下降（β = -0.19，P <.001）。但是，无论时间如何，牙齿越多与更好的认知功能相关（β = 0.01，P <.001）。牙齿数量与时间的交互作用显著（β = 0.01，P <.001），表明在控制其他协变量后，牙齿较多的参与者随时间推移认知衰退的速度比牙齿较少的参与者慢。
本研究表明，牙齿缺失与中国老年人认知功能衰退有关。需要进一步研究使用临床检查数据来检验认知衰退与口腔健康状况之间的联系。
