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Intern Med. 2019 May 15;58(10):1411-1416. doi: 10.2169/internalmedicine.1896-18. Epub 2019 Jan 10.

Tooth Loss-associated Cognitive Impairment in the Elderly: A Community-based Study in Japan.

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Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University Faculty of Medicine, Japan.
Department of Dentistry, Oral and Maxillofacial-Plastic and Reconstructive Surgery, Yamagata University Faculty of Medicine, Japan.
National Hospital Organization Yonezawa Hospital, Japan.
National Hospital Organization Yamagata Hospital, Japan.
Yamagata City Office, Japan.


Objective Dementia is a major cause of disruption for a healthy life expectancy in Japan. It has been suggested that the number of teeth is a modifiable risk factor for cognitive impairment and dementia. We therefore examined the possible association between the cognitive function and the number of natural and artificial teeth in community-dwelling Japanese elderly individuals. Methods Among the participants in our prospective, community-based study, 210 elderly individuals (103 men and 107 women; 78.1±4.9 years; mean age±standard deviation) underwent both dental examinations and a Mini-Mental State Examination (MMSE), as well as various medical checkups, in 2016 and 2017. Results The number of natural teeth was significantly associated with an individual's MMSE score. The percentage of cognitively normal subjects (MMSE scores: 27-30) decreased significantly with a decrease in the number of natural teeth. Among the MMSE items, the calculation ability was significantly and independently associated with the number of natural teeth. Regression was calculated as the predicted score of MMSE =21+0.3× (years of schooling) +0.1× (number of natural teeth). Among individuals with 19 or fewer natural teeth, those who had a total of 20 teeth or more, including both natural and artificial teeth, had significantly higher MMSE scores than those who had 19 or fewer natural and artificial teeth combined. Conclusion The number of natural teeth was significantly associated with the cognitive function, especially the calculation ability, and the use of artificial teeth was associated with the preservation of the cognitive function in community-dwelling elderly individuals.


artificial teeth; cognitive impairment; community-based study; dementia; mini-mental state examination; natural teeth

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