Journal
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
Volume 64, Issue 11, Pages 2336-2342Publisher
WILEY-BLACKWELL
DOI: 10.1111/jgs.14324
Keywords
oral health; propensity score; independent living; tooth loss
Categories
Funding
- Ministry of Education, Culture, Sports, Science and Technology-Japan
- Japan Society for the Promotion of Science KAKENHI [22330172, 22390400, 23243070, 23590786, 23790710, 24390469, 24530698, 24683018, 25253052, 25870573, 25870881, 26285138, 26882010, 15H01972]
- Health Labour Sciences Research Grants [H22-Choju-Shitei-008, H24-Jun-kanki [Seishu]-Ippan-007, H24-Chikyukibo-Ippan-009, H24-Choju-Wakate-009, H25-Kenki-Wakate-015, H25-Choju-Ippan-003, H26-Irryo-Shitei-003 [Fukkou], H26-Choju-Ippan-006, H27-Ninchisyou-Ippan-001]
- Japan Agency for Medical Research and Development
- National Center for Geriatrics and Gerontology [24-17, 24-23]
- Japan Foundation for Aging and Health [J09KF00804]
- 8020 Promotion Foundation [14-2-07]
- National Institute for Health Research [NF-SI-0515-10032] Funding Source: researchfish
- Grants-in-Aid for Scientific Research [25253052, 15H01972] Funding Source: KAKEN
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ObjectivesTo describe associations between tooth loss and changes in higher-level functional capacity. DesignProspective cohort study. SettingTwenty-four Japanese municipalities between 2010 and 2013. ParticipantsFunctionally independent community-dwelling persons aged 65 and older (N=62,333). MeasurementsSelf-reported number of teeth was used as an exposure variable. The outcome was changes in higher-level functional capacity measured using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), which consists of three domains: instrumental activities of daily living, intellectual activity, and social roles. The TMIG-IC score ranges from 0 (lowest function) to 13 (highest function). All covariates were chosen from baseline demographic, socioeconomic, health behavior, and health variables based upon evidence from previous studies. Inverse-probability weighting (IPW) with propensity score and multiple linear regression, estimating nonstandardized coefficients () and 95% confidence intervals (CIs), were used. ResultsThe baseline response rate was 65.2%, and the follow-up rate was 70.1%. During the follow-up period, participants' TMIG-IC score declined by an average of 0.247 points (standard deviation: 1.446). The results showed a significant dose-response association between tooth loss and decline in higher-level functional capacity in multiple linear regression models. IPW models estimated the increment in TMIG-IC score (=0.170, 95% CI=0.114 to 0.227) if edentulous participants gained 20 or more natural teeth. ConclusionTooth loss is associated with future decline in higher-level functional capacity. IPW models suggest that treatment for tooth loss attenuates decline in higher-level functional capacity.
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