Frontiers in Public Health (Jan 2024)

Frailty mediated the association between tooth loss and mortality in the oldest old individuals: a cohort study

  • MingXia Wang,
  • Xiaomeng Deng,
  • Hanjie Chen,
  • Yuhan Diao,
  • Chang Liu,
  • Jun Gao,
  • Jun Gao,
  • Xin Tang,
  • Xin Tang,
  • Xiaoyan Li,
  • Xiaoyan Li,
  • Yan Liu,
  • Jun Duan

DOI
https://doi.org/10.3389/fpubh.2023.1285226
Journal volume & issue
Vol. 11

Abstract

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IntroductionTooth loss is associated with increased mortality risk; however, the mechanism underlying this is still not clear. The objective of this study was to explore whether frailty mediates the association between tooth loss and mortality risk among the oldest old individuals.MethodsThe participants were followed up from 1998 to 2018 in the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Frailty was constructed following a standard procedure. Mortality, frailty, and tooth loss were applied as the outcome, mediator, and independent variables, respectively. The Cox model was fitted, including possible confounders, for causal mediation analysis. A total effect (TE), an average causal mediation effect (ACME), an average direct effect (ADE), and a proportion mediated (PM) effect were calculated.ResultsDuring the 129,936 person-years at risk, 31,899 individuals with a mean age of 91.79 years were included. The TE and ADE of severe tooth loss on mortality were 0.12 (95% CI: 0.08, 0.15) and 0.09 (95% CI: 0.05, 0.13); the ACME of frailty was 0.03 (95% CI: 0.02, 0.03) with 21.56% of the TE being mediated.DiscussionThis study illustrated that tooth loss is associated with mortality, and frailty appeared to mediate the relationship. It is recommended that oral health indicators and frailty status be incorporated into routine geriatric assessments to promote optimal oral health and non-frailty status.

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