title: Association between self-reported dental health status and onset of dementia: a 4-year prospective cohort study of older Japanese adults from the Aichi Gerontological Evaluation Study (AGES) Project.
abstract: OBJECTIVE
  Studies have shown that people with cognitive impairment have poor dental health. However, the direction of causality remains unknown. This prospective cohort study aimed to determine the association between four self-reported dental health variables and dementia onset in older Japanese people.
  
  
  METHODS
  Analysis was conducted on 4425 residents 65 years or older. Four self-reported dental health variables included the number of teeth and/or use of dentures, ability to chew, presence/absence of a regular dentist, and taking care of dental health. Data were collected using self-administered questionnaires given in 2003. Records of dementia onset during 2003 to 2007 were obtained from municipalities in charge of the public long-term care insurance system. Age, income, body mass index, present illness, alcohol consumption, exercise, and forgetfulness were used as covariates.
  
  
  RESULTS
  Dementia onset was recorded in 220 participants. Univariate Cox proportional hazards models showed significant associations between the dental health variables and dementia onset. In models fully adjusted for all covariates, hazard ratios (95% confidence intervals) of dementia onset of respondents were as follows: 1.85 (1.04-3.31) for those with few teeth and without dentures; 1.25 (0.81-1.93) for those who could not chew very well; 1.44 (1.04-2.01) for those who did not have a regular dentist; and 1.76 (0.96-3.20) for those who did not take care of their dental health.
  
  
  CONCLUSIONS
  Few teeth without dentures and absence of a regular dentist, not poor mastication and poor attitudes toward dental health, were associated with higher risk of dementia onset in the older Japanese cohort even after adjustment for available covariates.
authors.affiliation: Division of Sociological Approach in Dentistry, Department of Dental Sociology, Kanagawa Dental College, 82 Inaoka-cho, Yokosuka, Kanagawa 238-8580, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Kondo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hirai
authors.forename: Miyo
authors.initials: M
authors.lastname: Nakade
authors.forename: Jun
authors.initials: J
authors.lastname: Aida
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hirata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D003704:Dementia / Q000453:epidemiology*; D016321:Dental Care for Aged / Q000706:statistics & numerical data; D003778:Dentures; D004812:Epidemiologic Methods; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data*; D014076:Tooth Diseases / Q000453:epidemiology* / Q000628:therapy