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台湾老年成年人牙齿缺失、使用假牙与痴呆症之间的关联。

Associations between tooth loss, denture use, and dementia in older Taiwanese adults.

作者信息

Chen Yi-Wen, Li Chung-Yi, Lee Shang-Chi, Ku Li-Jung Elizabeth, Chou Yu-Tsung, Hargono Arief, Chiu Chang-Ta, Hou Wen-Hsuan

机构信息

Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.

Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2025 Jan 1;88(1):43-51. doi: 10.1097/JCMA.0000000000001171. Epub 2024 Sep 20.

Abstract

BACKGROUND

The literature has mainly focused on the association between tooth loss and dementia, and evidence regarding the separate and joint effects of tooth loss and denture use on the risk of dementia is limited. This study investigated the links among tooth loss, denture use, and dementia risk in Taiwanese adults aged 65 years or older.

METHODS

This retrospective cohort study utilized data from the 2009 National Health Interview Survey and 2008-2017 National Health Insurance claim records, including the records of 2247 individuals free from dementia treatment in 2008-2009. Dementia diagnoses were tracked until 2017. The Cox proportional hazards model was used to calculate hazard ratios (HRs) for exploring the correlations among tooth loss, denture use, and dementia risk.

RESULTS

Older adults with 20 or more natural teeth and dentures had the lowest dementia incidence (1.43 per 100 person-years). Those with <20 natural teeth, with or without dentures, experienced high dementia incidence rates of 2.31 and 3.33 per 100 person-years, respectively. After adjusting for various factors (i.e., sociodemographic characteristics, health conditions/comorbidities, and lifestyles), having <20 natural teeth or not using dentures was associated with non-significantly increased HRs of 1.30 (95% CI, 0.99-1.71) and 1.20 (95% CI, 0.95-1.52). Subgroup analysis revealed that compared to older adults with 20 or more natural teeth and dentures, those with <20 natural teeth and not wearing dentures had a significantly increased risk of dementia (adjusted HR, 1.57; 95% CI, 1.04-2.37).

CONCLUSION

This study found that having <20 natural teeth and not using dentures was significantly associated with an increased risk of dementia in Taiwanese individuals aged 65 years or above.

摘要

背景

文献主要聚焦于牙齿缺失与痴呆症之间的关联,而关于牙齿缺失和使用假牙对痴呆症风险的单独及联合影响的证据有限。本研究调查了台湾65岁及以上成年人牙齿缺失、使用假牙与痴呆症风险之间的联系。

方法

这项回顾性队列研究利用了2009年国民健康访谈调查和2008 - 2017年国民健康保险理赔记录的数据,其中包括2008 - 2009年2247名未接受痴呆症治疗的个体的记录。追踪痴呆症诊断直至2017年。采用Cox比例风险模型计算风险比(HRs),以探索牙齿缺失、使用假牙与痴呆症风险之间的相关性。

结果

拥有20颗及以上天然牙且佩戴假牙的老年人痴呆症发病率最低(每100人年1.43例)。天然牙少于20颗的人,无论是否佩戴假牙,痴呆症发病率分别为每100人年2.31例和3.33例,均较高。在调整各种因素(即社会人口统计学特征、健康状况/合并症和生活方式)后,天然牙少于20颗或不使用假牙与HRs分别非显著增加1.30(95%CI,0.99 - 1.71)和1.20(95%CI,0.95 - 1.52)相关。亚组分析显示,与拥有20颗及以上天然牙且佩戴假牙的老年人相比,天然牙少于20颗且未佩戴假牙的人患痴呆症的风险显著增加(调整后HR,1.57;95%CI,1.04 - 2.37)。

结论

本研究发现,对于台湾65岁及以上的个体,天然牙少于20颗且不使用假牙与痴呆症风险增加显著相关。

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