Poor oral health and dementia risk under time‐varying confounding: A cohort study based on marginal structural models

医学 混淆 痴呆 危险系数 比例危险模型 置信区间 队列研究 队列 边际结构模型 入射(几何) 老年学 内科学 疾病 光学 物理
作者
Taro Kusama,Kenji Takeuchi,Sakura Kiuchi,Jun Aida,Ken Osaka
出处
期刊:Journal of the American Geriatrics Society [Wiley]
卷期号:72 (3): 729-741 被引量:4
标识
DOI:10.1111/jgs.18707
摘要

Abstract Background Bidirectional association between oral health, including tooth loss and oral hypofunction, and cognitive impairment can induce time‐varying confounding in association with dementia. This study aimed to investigate the association between oral health and the development of dementia among older adults, considering cognitive impairment as a time‐varying confounder. Methods This nine‐year follow‐up cohort study targeted independent older adults aged ≥65 years who participated in the Japan Gerontological Evaluation Study. The exposure variables were self‐reported poor oral health (≤19 remaining teeth, edentulousness, chewing difficulty, swallowing problems, and xerostomia), which were assessed in 2010 and 2013. The outcome variable was the incidence of dementia between 2013 and 2019, which was obtained from the municipalities' administrative database. Furthermore, in 2010 and 2013, we considered cognitive impairment as a time‐varying confounder and treated it based on a marginal structural model (MSM), including possible baseline confounders. Oral health and cognitive impairment were assessed using the items of Kihon checklist. We employed a Cox proportional hazards model with a stabilized inverse probability weight and estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Results Among 37,556 participants (mean age: 72.8 years [1 SD = 5.5], males: 46.8%), the dementia incidence rate was 2.2/100 person‐year. The proportions of those with ≤19 remaining teeth, edentulousness, chewing difficulty, swallowing problems, and xerostomia were 61.3%, 11.0%, 24.4%, 14.7%, and 19.2%, respectively. From the regression analysis based on MSM, ≤19 remaining teeth (HR = 1.12, 95% CI = 1.03–1.23), edentulousness (HR = 1.20, 95% CI = 1.09–1.32), chewing difficulty (HR = 1.11, 95% CI = 1.02–1.21), and xerostomia (HR = 1.10, 95% CI = 1.01–1.20) were significantly associated with an increased risk of dementia; however, swallowing problems were not significantly associated with dementia onset ( p > 0.05). Conclusions Even after considering time‐varying confounding by cognitive function at baseline and follow‐up, we observed significant associations between poor oral health and increased risk of dementia among older adults.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
闵不悔完成签到,获得积分10
2秒前
阳光火车完成签到 ,获得积分10
3秒前
cc完成签到,获得积分10
6秒前
合适的寄灵完成签到 ,获得积分10
7秒前
量子星尘发布了新的文献求助10
8秒前
科研通AI5应助cc采纳,获得10
9秒前
铜泰妍完成签到 ,获得积分10
10秒前
贝贝完成签到 ,获得积分10
15秒前
Lrcx完成签到 ,获得积分10
16秒前
Wen完成签到 ,获得积分10
17秒前
盘尼西林完成签到 ,获得积分10
19秒前
LOVE0077完成签到,获得积分10
22秒前
zhao完成签到,获得积分10
24秒前
BINBIN完成签到 ,获得积分10
34秒前
ambrose37完成签到 ,获得积分10
36秒前
量子星尘发布了新的文献求助10
42秒前
fufufu123完成签到 ,获得积分10
46秒前
开心的大娘完成签到,获得积分10
46秒前
www完成签到 ,获得积分10
48秒前
末末完成签到 ,获得积分10
58秒前
无为完成签到 ,获得积分10
59秒前
白嫖论文完成签到 ,获得积分10
1分钟前
上官若男应助忧伤的步美采纳,获得10
1分钟前
科研通AI2S应助科研通管家采纳,获得10
1分钟前
1分钟前
从心随缘完成签到 ,获得积分10
1分钟前
花花发布了新的文献求助10
1分钟前
牛奶面包完成签到 ,获得积分10
1分钟前
1分钟前
岁月如歌完成签到 ,获得积分0
1分钟前
1分钟前
Li完成签到,获得积分10
1分钟前
张琨完成签到 ,获得积分10
1分钟前
1分钟前
sunnyqqz完成签到,获得积分10
1分钟前
热情的乘风完成签到,获得积分20
1分钟前
1分钟前
霍凡白完成签到,获得积分10
1分钟前
1分钟前
Feng发布了新的文献求助20
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038039
求助须知:如何正确求助?哪些是违规求助? 3575756
关于积分的说明 11373782
捐赠科研通 3305574
什么是DOI,文献DOI怎么找? 1819239
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022