Association of oral health and chewing ability with cognitive impairment and dementia in older adults: Longitudinal findings from a national panel study

초록

Objective: Recent studies suggest that poor oral health may contribute to cognitive impairment. However, most previous studies were cross-sectional, limiting conclusions regarding temporal relationships. Using nationally representative data, we investigated the longitudinal association between oral health and the development of mild cognitive impairment (MCI) or dementia among adults aged ≥45 years, with a specific focus on those aged ≥65 years. Methods: Data from the Korean Longitudinal Study of Aging were analyzed. Adults aged ≥45 years without dementia were followed up from 2018 to 2022. Baseline oral health was assessed using the Geriatric Oral Health Assessment Index (GOHAI) and self-reported chewing ability. Cases of MCI or dementia were identified using self-reported physician diagnoses during follow-up. Cox proportional hazard models were used to estimate the hazard ratios (HR) for developing MCI/dementia according to baseline oral health. Analyses were performed separately by sex and included a subgroup analysis of participants aged ≥65 years. Results: Over the 4-year follow-up, participants with higher GOHAI scores exhibited significantly lower risks of cognitive impairment (adjusted HR: 0.98 per point increase, 95 % confidence interval (CI): 0.96–0.99). Participants reporting good chewing ability had approximately half the risk of cognitive decline compared with those reporting chewing difficulties (adjusted HR: 0.50, 95 %CI: 0.35–0.75). This association remained significant across sexes and within the subgroup aged ≥65 years. Conclusions: Improved oral health and preserved chewing ability were significantly associated with a reduced risk of cognitive impairment and dementia, suggesting a potential role for oral health in dementia prevention strategies. © 2025 Elsevier B.V.

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