February 14, 2024
Article

How Smoking and Tooth Loss Link to Dementia Risk in Older Adults

In recent research, a fascinating connection has been discovered between smoking, tooth loss, and an increased risk of developing dementia in later life. Delving into the intricate relationship between these factors, the study reveals that tooth loss acts as a significant mediator, essentially serving as a bridge that links smoking to a heightened risk of dementia. This finding is particularly noteworthy because it underscores the importance of oral health and its broader implications on our cognitive well-being as we age.

The research, which followed over 32,000 participants for nine years, found that individuals who had smoked in the past or were current smokers and also suffered from tooth loss had a slightly higher chance of developing dementia compared to those who never smoked. Specifically, the risk increased by a factor of 1.03 for those with fewer teeth, highlighting an 18% mediation effect of tooth loss on the smoking-dementia link. These numbers may seem small, but they represent a significant public health insight, suggesting that maintaining dental health could be a key strategy in reducing dementia risk among older adults.

The implications of this study are profound, suggesting that interventions focusing on reducing smoking rates and promoting oral health could play a crucial role in mitigating dementia risk. It's a call to action for individuals to consider the long-term effects of their lifestyle choices on their cognitive health. Ensuring good dental hygiene and avoiding smoking may not just save your teeth, but also preserve your memory and cognitive functions into old age.

Article Information

Abstract

Aim: Tooth loss has various causes; however, its cause-specific effects on health outcomes remain unclear. This study evaluated whether the association between past/current smoking and risk of dementia was mediated by tooth loss.

Materials and methods: This 9-year-follow-up prospective cohort study targeted adults aged ≥65 years. Dementia incidence during 2013-2019, smoking status (never, past/current) in 2010 and the number of remaining teeth (≤19, ≥20) in 2013 were the outcome, exposure and mediator, respectively. We used causal mediation analysis to fit the Cox proportional hazards model and estimated the hazard ratio (HR) and 95% confidence interval (CI) of the natural indirect effect (NIE) of smoking on dementia incidence through tooth loss and their mediated proportions.

Results: Among 32,986 participants (mean age 72.6 years [1 SD = 5.4]; men 48.4%), the dementia incidence during follow-up was 2.11/100 person-years. Tooth loss significantly mediated the association between past/current smoking and dementia incidence; the NIE of fewer remaining teeth for past/current smokers compared to never smokers was HR = 1.03 (95% CI: 1.02-1.05), and the mediated proportion was 18.0%.

Conclusions: Tooth loss significantly mediates the association between past/current smoking and an increased risk of dementia among older adults.