Department of Global Health Promotion, Tokyo Medical and Dental University (YM, TF), Tokyo, Japan.
Department of Global Health Promotion, Tokyo Medical and Dental University (YM, TF), Tokyo, Japan.
Am J Geriatr Psychiatry. 2022 Dec;30(12):1271-1279. doi: 10.1016/j.jagp.2022.06.005. Epub 2022 Jun 17.
We investigated the association between tooth loss and structural brain volume and its mediating effect on the association between tooth loss and cognitive function in older Japanese.
A cross-sectional study was conducted by using the data of 494 randomly sampled community-dwelling individuals aged 65-84 years living in Tokamachi City, Japan. Total brain volume (TBV), gray matter volume (GMV), white matter volume (WMV), and hippocampal volume (HV) were measured with magnetic resonance imaging. The association of self-reported number of teeth (≥20, 1-19, and 0) with cognitive function assessed with the Japanese version of the Quick Mild Cognitive Impairment screen and structural brain volume was examined. Causal mediation analysis was performed to evaluate the mediating effect of structural brain volume. Age, sex, socioeconomic status, health behavior, comorbid conditions, and total intracranial volume were adjusted.
Respondents with no teeth showed lower cognitive function (coefficient = -4.01; 95% confidence interval [CI]: -7.19, -0.82), lower TBV (coefficient = -10.34; 95% CI: -22.84, 2.17), and lower GMV (coefficient = -6.92; 95% CI: -14.84, 0.99) than those with ≥20 teeth (P for trends were 0.003, 0.035, and 0.047, respectively). The number of teeth was not significantly associated with WMV or HV. GMV showed a significant mediating effect on the association between the number of teeth and cognitive function (coefficient = -0.38; 95% CI: -1.14, -0.002, corresponding to 9.0% of the total effect), whereas TBV did not.
GMV was suggested to mediate the relationship between tooth loss and lower cognitive function.
我们研究了牙齿缺失与大脑结构体积之间的关联，以及其在牙齿缺失与认知功能之间的关联中的中介作用。
采用日本富冈市随机抽样的 494 名 65-84 岁社区居民的数据进行横断面研究。采用磁共振成像测量总脑容量（TBV）、灰质体积（GMV）、白质体积（WMV）和海马体积（HV）。使用日本版快速轻度认知障碍筛查评估的认知功能与自我报告的牙齿数量（≥20、1-19 和 0）的相关性进行了检查。进行因果中介分析以评估结构脑容量的中介作用。调整年龄、性别、社会经济状况、健康行为、合并症和总颅内体积。
无牙者的认知功能较低（系数=-4.01；95%置信区间[CI]：-7.19，-0.82），TBV 较低（系数=-10.34；95%CI：-22.84，2.17），GMV 较低（系数=-6.92；95%CI：-14.84，0.99）与≥20 颗牙的人相比（P 趋势值分别为 0.003、0.035 和 0.047）。牙齿数量与 WMV 或 HV 无显著相关性。GMV 对牙齿数量与认知功能之间的关联具有显著的中介作用（系数=-0.38；95%CI：-1.14，-0.002，占总效应的 9.0%），而 TBV 则没有。
GMV 被认为介导了牙齿缺失与较低认知功能之间的关系。
