Tooth loss is tied to faster progression to dementia and death
In 22,205 older adults followed for 12.3 years, complete tooth loss increased the transition risk from mild cognitive impairment to dementia with a hazard ratio of 1.26.
Journal of Alzheimer's Disease
A prospective cohort study evaluated 22,205 adults aged 50 years or older from China, the United States, and England over a median follow-up of 12.3 years. Researchers tracked how complete tooth loss, or edentulism, influenced transitions across cognitive states and mortality. At baseline, edentulism affected 7.41% of Chinese, 21.64% of US, and 14.24% of English participants.
Over the follow-up period, 60.1% of participants developed mild cognitive impairment, 13.6% of those progressed to dementia, and 36.0% died after dementia. Multi-state Markov models adjusted for sociodemographic, behavioral, and health covariates showed that edentulism significantly increased the risk of transitioning from mild cognitive impairment to dementia (hazard ratio 1.26) and from baseline to death (hazard ratio 1.27). The corresponding population attributable fractions were 6.52% for progression to dementia and 4.58% for death.
Why it matters
The findings highlight oral health as a key factor along the cognitive aging continuum. Maintaining dentition could offer a potential target to delay dementia progression and lower mortality in late life.
Caveats
Because this study is observational, it identifies statistical associations rather than direct causal mechanisms between tooth loss, dementia progression, and death.
The paper
Edentulism and cognitive transitions: A multi-state analysis
Tongji University · Shanghai Tenth People's Hospital
Journal of Alzheimer's Disease · 28 Sep 2026