Winning Lewis, Logan Danielle, McEvoy Claire T, Farsi Dominic, McKay Gareth J, Patterson Christopher C, Passmore Peter, Holmes Clive, Linden Gerard J, McGuinness Bernadette
Dublin Dental University Hospital, Trinity College Dublin, Lincoln Place, Dublin 2 D02 F859, Ireland.
Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Institute of Clinical Sciences, Royal Victoria Hospital, Belfast BT12 6BA, United Kingdom.
J Nutr Health Aging. 2025 Jun 27;29(9):100620. doi: 10.1016/j.jnha.2025.100620.
To investigate the association between tooth loss and the incidence of mild cognitive impairment (MCI) and dementia, focusing on diet quality as a potential mediator.
Prospective cohort study.
Community-dwelling older men enrolled in the Northern Ireland PRIME study (Prospective Epidemiological Study of Myocardial Infarction).
A group of men, aged 58-71 years, underwent dental examinations in 2001-2003. Surviving participants were invited to attend a cognitive rescreening in 2016-2020, which included a food frequency questionnaire. Cognitive outcomes were categorised as normal, MCI or dementia, based on standardised neurocognitive tests. Dietary diversity scores (DDS) were calculated based on the frequency of intake of food groups. Analyses included multiple logistic regression to evaluate the associations between tooth loss, defined as <20 remaining natural teeth, and MCI/dementia incidence adjusting for potential confounders. Mediation analysis assessed the role of diet quality in this relationship.
A total of 628 men were included, with a mean baseline age of 63.2 years (SD 2.8) and a median follow-up of 15.0 years (IQR 14.2-17.0). At rescreening, 485 (77.2%) were cognitively normal, 112 (17.8%) had MCI, and 31 (4.9%) had dementia. In fully adjusted models, tooth loss was significantly associated with MCI/dementia (OR = 2.06, 95% CI 1.20-3.55, p < 0.01). DDS partially mediated this relationship, explaining approximately 23% of the total effect.
In this cohort of older men, tooth loss was associated with incidence of MCI/dementia over 15 years, and diet diversity partially mediated this association. These findings highlight an important pathway connecting oral health, dietary quality, and cognitive outcomes.
研究牙齿缺失与轻度认知障碍（MCI）及痴呆症发病率之间的关联，重点关注饮食质量作为潜在中介因素的作用。
前瞻性队列研究。
纳入北爱尔兰PRIME研究（心肌梗死前瞻性流行病学研究）中的社区居住老年男性。
一组年龄在58 - 71岁的男性在2001 - 2003年接受了牙科检查。存活的参与者被邀请在2016 - 2020年参加认知复查，其中包括一份食物频率问卷。根据标准化神经认知测试，认知结果分为正常、MCI或痴呆。基于食物组的摄入频率计算饮食多样性得分（DDS）。分析包括多因素逻辑回归，以评估牙齿缺失（定义为剩余天然牙少于20颗）与MCI/痴呆症发病率之间的关联，并对潜在混杂因素进行调整。中介分析评估饮食质量在这种关系中的作用。
共纳入628名男性，平均基线年龄为63.2岁（标准差2.8），中位随访时间为15.0年（四分位间距14.2 - 17.0）。在复查时，485人（77.2%）认知正常，112人（17.8%）患有MCI，31人（4.9%）患有痴呆。在完全调整模型中，牙齿缺失与MCI/痴呆症显著相关（比值比 = 2.06，95%置信区间1.20 - 3.55，p < 0.01）。DDS部分介导了这种关系，解释了总效应的约23%。
在这组老年男性中，牙齿缺失与15年内MCI/痴呆症的发病率相关，饮食多样性部分介导了这种关联。这些发现突出了连接口腔健康、饮食质量和认知结果的重要途径。
