title: Tooth loss associated with physical and cognitive decline in older adults.
abstract: OBJECTIVE
  To examine the effect of total tooth loss (edentulousness) on decline in physical and cognitive functioning over 10 years in older adults in England.
  
  
  METHODS
  Secondary data analysis.
  
  
  METHODS
  English Longitudinal Study of Ageing, a national prospective cohort study of community-dwelling people aged 50 and older.
  
  
  METHODS
  Individuals aged 60 and older (N = 3,166).
  
  
  METHODS
  Cognitive function (memory) was measured using a 10-word recall test. Physical function was assessed using gait speed (m/s). Generalized estimating equations were used to model associations between baseline edentulousness and six repeated measurements of gait speed and memory from 2002-03 to 2012-13. Models were sequentially adjusted for time, demographic characteristics, socioeconomic status, comorbidities, health behaviors, depressive symptoms, and anthropometric measurements and mutually adjusted for gait speed or memory.
  
  
  RESULTS
  Edentulous participants recalled 0.88 fewer words and were 0.09 m/s slower than dentate participants after adjusting for time and demographics. Only the latter association remained significant after full adjustment, with edentulous participants being 0.02 m/s slower than dentate participants. In age-stratified analyses, baseline edentulousness was associated with both outcomes in fully adjusted models in participants aged 60 to 74 but not in those aged 75 and older. Supplementary analysis indicated significant associations between baseline edentulousness and 4-year change in gait speed and memory in participants aged 60 to 74; the former was fully explained in the fully adjusted model and the latter after adjusting for socioeconomic status.
  
  
  CONCLUSIONS
  Total tooth loss was independently associated with physical and cognitive decline in older adults in England. Tooth loss is a potential early marker of decline in older age.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsakos
authors.forename: Richard G
authors.initials: RG
authors.lastname: Watt
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Rouxel
authors.forename: Cesar
authors.initials: C
authors.lastname: de Oliveira
authors.forename: Panayotes
authors.initials: P
authors.lastname: Demakakos
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010808:Physical Examination; D011446:Prospective Studies; D012307:Risk Factors; D016388:Tooth Loss / Q000150:complications* / Q000453:epidemiology*
keywords: cognitive function; edentulous; longitudinal studies; physical function; tooth loss