Tooth loss and periodontal disease predict poor cognitive function in older men.
OBJECTIVE
To determine whether rates of tooth loss, periodontal disease progression, and caries incidence predict cognitive decline in men.


METHODS
Prospective study.


METHODS
Community-dwelling men enrolled in the Veterans Affairs Dental Longitudinal Study.


METHODS
Five hundred ninety-seven dentate men aged 28 to 70 at study baseline who have been followed up to 32 years.


METHODS
Oral examinations were conducted approximately every 3 years. Periodontal disease measures included probing pocket depth and radiographic alveolar bone height. Participants underwent cognitive testing beginning in 1993. Low cognitive status was defined as less than 25 points or less than 90% of the age- and education-specific median on the Mini-Mental State Examination (MMSE) and less than 10 points on a spatial copying task.


RESULTS
Each tooth lost per decade since the baseline dental examination increased the risks of low MMSE score (hazard ratio (HR)=1.09, 95% confidence interval (CI)=1.01-1.18) and low spatial copying score (HR=1.12, CI=1.05-1.18). Risks were greater per additional tooth with progression of alveolar bone loss (spatial copying: HR=1.03, CI=1.01-1.06), probing pocket depth (MMSE: HR=1.04, CI=1.01-1.09; spatial copying: HR=1.04, CI=1.01-1.06), and caries (spatial copying: HR=1.05, CI=1.01-1.08). Risks were consistently higher in men who were older than 45.5 at baseline than in younger men.


CONCLUSIONS
Risk of cognitive decline in older men increases as more teeth are lost. Periodontal disease and caries, major reasons for tooth loss, are also related to cognitive decline.
Kaye
Elizabeth Krall
EK
Veterans Affairs Boston Healthcare System, Boston, Massachusetts, USA. kralle@bu.edu
Valencia
Aileen
A
Baba
Nivine
N
Spiro
Avron
A
Dietrich
Thomas
T
Garcia
Raul I
RI
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001900:Boston / Q000453:epidemiology; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D003731:Dental Caries / Q000150:complications* / Q000175:diagnosis; D003753:Dental Health Surveys; D018450:Disease Progression; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010510:Periodontal Diseases / Q000150:complications* / Q000175:diagnosis; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016388:Tooth Loss / Q000150:complications* / Q000175:diagnosis
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