Prospective Tooth Loss Predicts Poor Cognitive Function in Older Men

Methods: 641 VA Dental Longitudinal Study participants, with triennial clinical examinations between 1969 and 2007, completed Mini-Mental State Examinations (MMSE) and spatial copying tests (SC) since 1993. Subjects are not VA patients, but receive medical and dental care in the private sector. Number of teeth present was counted at each examination: only 15% of men had fewer than 20 teeth at baseline, while 78% lost one or more teeth during follow-up. Data on smoking status, diet and education were obtained by self-report. Presence of coronary heart disease (CHD) was determined by study physicians. Differences in mean test scores between tooth loss groups were assessed with analysis of covariance. Multiple logistic regression estimated the odds of having a low score on the MMSE (<25) or being in the lowest quartile of SC scores. All analyses were adjusted for baseline age, education, CHD diagnosis (yes/no), percent Kilocalories from alcohol, and smoking history (ever/never).

Results: Mean (±se) age at baseline was 46±7 years. Compared to men with 20+ teeth at baseline, men with <20 teeth scored lower on MMSE (27.2±0.2 vs 27.7±0.1, p=0.03) and SC tests (13.5±0.6 vs 14.8±0.2, p=0.04) 24 years later. Men who lost teeth since baseline scored lower on both MMSE (27.5±0.1 vs 28.0±0.2, p=0.02) and SC tests (14.4±0.3 vs 15.5±0.5, p<.05) than men who lost no teeth. Loss of any teeth was associated with 4.5 greater odds of a low MMSE score (p=0.04) and 1.9 greater odds of a low SC score (p=0.02).

Conclusions: Tooth loss is an independent predictor of subsequent cognitive function.

Supported by US Dept. of Veterans Affairs and NIDCR K24 DE00419.