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Neuroscience/Nutrition and the Brain (Poster Session)

(P09-040-25) Tooth Loss, Dietary Quality and Cognitive Impairment: Two Prospective Cohort Studies

Saturday, May 31, 2025
12:45 PM - 1:45 PM ET
Location: Poster Board D-39

    Presenting Author(s)

  • Mengjia Zhao, MPH

    866, Yuhangtang Road, Hangzhou, China 310058
    The Second Affiliated Hospital, Zhejiang University School of Medicine, School of Public Health
    Hangzhou, Zhejiang, China (People's Republic)

    • Co-Author(s)

  • JS

    Jie Shen, n/a

    PhD student
    Zhejiang University
    Hangzhou, Zhejiang, China (People's Republic)

  • SQ

    Shujiao QIan

    Department of Oral Implantology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center of Stomatology; National Clinical Research Center for Oral Diseases; Shanghai key Laboratory of Stomatology, Shanghai

  • KD

    Ke Deng

    University of Hong Kong, Hong Kong

  • GP

    George Pelekos

    University of Hong Kong, Hong Kong

  • MT

    Maurizio Tonetti

    Department of Oral Implantology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center of Stomatology; National Clinical Research Center for Oral Diseases; Shanghai key Laboratory of Stomatology, Shanghai

  • CY

    Changzheng Yuan, ScD

    School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou

Disclosure(s):
Mengjia Zhao, MPH: No relevant financial relationship(s) with ineligible companies to disclose.


Objectives: To investigate the independent and combined associations of tooth loss and dietary quality with cognitive impairment in two prospective cohort studies.

Methods: We included 9,589 participants from the Chinese Longitudinal Healthy Longevity Survey (CLHLS, 2000-2018) and 5,652 U.S. participants from the Health and Retirement Study (HRS, 2012-2020). Participants were categorized as edentulous (number of natural teeth = 0) or dentulous (number of natural teeth > 0). Dietary quality was evaluated using the dietary diversity score (DDS) in CLHLS and the Alternate Healthy Eating Index 2010 (AHEI-2010) in HRS. Cognitive impairment was measured by the Chinese version of the Mini-Mental State Examination (CM-MMSE) in CLHLS and the Telephone Interview for Cognitive Status-Modified (TICS-m) in HRS. Multivariable Cox proportional hazard regression models were used to examine the corresponding associations.

Results: Over 84,701 person-years’ follow-up, 1,740 CLHLS participants (mean [SD] age, 85.5 [10.0] years; 1,164 female [66.9%]) and 1,173 HRS participants (mean [SD] age, 70.1 [11.0] years; 714 female [60.9%]) developed cognitive impairment. After multivariable adjustment, we observed independent associations of tooth loss and diet quality with cognitive impairment. Specifically, dentulous individuals had a lower risk of cognitive impairment compared to edentulous individuals (hazard ratio [HR] = 0.84, 95% confidence interval [CI]: 0.75-0.94 in CLHLS; HR = 0.78, 95% CI: 0.67-0.91 in HRS). Similarly, individuals in the highest tertile of dietary quality exhibited lower risk for cognitive impairment compared to those in the lowest tertile (HR = 0.79, 95% CI: 0.69-0.90 and HR = 0.83, 95% CI: 0.70-0.99, respectively). Notably, participants with both dentulous status and better dietary quality demonstrated the lowest risk of cognitive impairment (HR = 0.70, 95% CI: 0.58-0.84 in CLHLS; HR = 0.66, 95% CI: 0.51-0.85 in HRS).

Conclusions: Dentulous status and better dietary quality are independently associated with lower risks of cognitive impairment in older adults. Their combination demonstrated the greatest protective association. Promoting dental health and dietary quality among older adults could be considered in prevention strategies for cognitive impairment.

Funding Sources: No funding was received.