Denture Use Linked to Cognitive Decline in Older Adult

A recently published study in the journal Aging Medicine sheds light on the potential relationship between denture use and cognitive health among older adults in China. The research, authored by Xiang Qi, Zheng Zhu, Yaolin Pei, and Bei Wu, examines data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) spanning 2008 to 2018, focusing on over 27,000 adults aged 65 and older who experienced varying degrees of tooth loss. The findings highlight significant associations between denture use and cognitive outcomes, emphasizing the importance of prosthodontic rehabilitation for aging populations.

Research Methodology and Population

The study analyzed data from a robust sample of 27,708 community-dwelling older adults, including both dentate (those with some natural teeth remaining) and edentulous (those who have lost all natural teeth) participants. Cognitive function was measured using the Mini-Mental State Examination (MMSE) over a decade. Linear mixed-effect models were employed to evaluate the relationship between denture use, baseline cognitive function, and the rate of cognitive decline. Adjustments were made for sociodemographic factors, health behaviors, and health status to ensure accuracy.

The analysis included subgroup evaluations based on the extent of tooth loss among dentate participants, categorized into groups of 1–9, 10–19, and 20–31 missing teeth. The researchers excluded participants under 65, those with self-reported dementia at baseline, and residents of nursing homes.

Key Findings: Denture Use and Cognitive Health

The results indicate that denture use is associated with better baseline cognitive function and a slower rate of cognitive decline among participants with partial tooth loss. Specifically, dentate participants who wore dentures demonstrated higher baseline cognitive scores (β = 1.032; 95% CI, 0.813–1.251; p < 0.001) and experienced a slower annual decline in cognitive function (β = 0.127; 95% CI, 0.047–0.206; p < 0.01) compared to their counterparts who did not use dentures.

In contrast, edentulous participants who used dentures exhibited higher baseline cognitive function (β = 3.063; 95% CI, 2.703–3.423; p < 0.001) but showed no significant association with the rate of cognitive decline (β = 0.011; 95% CI, –0.082 to 0.105; p = 0.818).

Implications for Prosthodontic Rehabilitation

The findings support the notion that denture use may serve as a protective factor against cognitive decline, particularly for older adults with partial tooth loss. “Denture use has been shown to improve nutritional intake and diet quality in people with tooth loss,” the authors note, highlighting the importance of maintaining oral function through prosthodontic interventions.

Furthermore, the study emphasizes the interconnectedness of oral health, masticatory function, and cognitive well-being. Previous research cited in the article suggests that impaired chewing ability can negatively impact cerebral blood flow and oxygenation in brain regions critical for cognitive health, such as the prefrontal cortex and hippocampus.

Broader Context and Future Directions

China’s aging population and high prevalence of dementia—accounting for 25% of global cases—underscore the urgency of identifying modifiable risk factors for cognitive decline. This study adds to the growing body of evidence linking oral health and cognitive outcomes, but the authors stress the need for further research to establish causality.

“While the benefits of denture use in terms of improved masticatory function are recognized, there is a notable scarcity of comprehensive, well-structured prospective studies investigating the impact of denture use on cognitive outcomes,” the authors write. Future research could explore additional mechanisms and long-term effects of prosthodontic rehabilitation on cognitive health.

Conclusion

The study by Xiang Qi and Zheng Zhu, published in Aging Medicine on December 23, 2024, provides valuable insights into the role of denture use in supporting cognitive health among older adults with tooth loss. By addressing knowledge gaps in this area, the findings have practical and policy implications for aging populations worldwide. As the authors conclude, “Denture use may help protect against cognitive decline in older adults with partial tooth loss.”

For further information, the full study is accessible via Wiley Online Library.