Chewing Ability and Tooth Loss: Association with Cognitive Impairment in an Elderly Population Study

Objectives To determine whether there is an association between tooth loss, chewing ability, and cognitive function in a general elderly population. Design Data from the Panel Study of Living Conditions of the Oldest Old in 2002 were analyzed. Stepwise logistic regression analyses were used to examine the relationship between cognitive function and tooth loss and chewing ability. Participants Five hundred fifty-seven persons who were nationally representative of the Swedish population aged 77 and older. Measurements Cognitive function was measured using the abridged version of the Mini-Mental State Examination. Information on dental status and chewing difficulty was obtained according to self-assessment. Results Persons with multiple tooth loss and persons with difficulty chewing hard food had significantly higher odds of cognitive impairment. When adjusted for sex, age, and education, the odds of cognitive impairment were not significantly different between persons with natural teeth and with multiple tooth loss, but the odds of impairment remained significantly higher for persons with chewing difficulty even when adjusted for sex, age, education, depression, and mental illness. Conclusion Sex, age, education, and certain illnesses do not explain the association between cognition and chewing ability. Whether elderly persons chew with natural teeth or prostheses may not contribute significantly to cognitive impairment as long as they have no chewing difficulty. The results add to the evidence of the association between chewing ability and cognitive impairment in elderly persons.