Oral health variables associated with factors across the Alzheimer's disease continuum: from subjective cognitive decline to dementia

Shih-Yun Wu¹, Ching-Yi Wu², Yung-Shuan Lin³, Chia-Shu Lin⁴, Wei-Ju Lee⁵, Ssu-Jung He⁶, Guo-Hao Lin⁷, Hsin-Yi Huang⁸, Jong-Ling Fuh⁹

Affiliations

¹ Department of Stomatology, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan; College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Department of Orofacial Sciences, School of Dentistry, University of California, No. 707 Parnassus Ave, San Francisco, CA, 94143, USA.
² Institute of Oral Biology, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan.
³ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan.
⁴ College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Oral Medicine Innovation Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan.
⁵ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Neurological Institute, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sect. 4, Taichung, 407219, Taiwan; Dementia Center, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sect. 4, Taichung, 407219, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, No. 145 Xingda Rd., South Dist., Taichung City 402202, Taiwan.
⁶ Department of Stomatology, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan.
⁷ Department of Orofacial Sciences, School of Dentistry, University of California, No. 707 Parnassus Ave, San Francisco, CA, 94143, USA.
⁸ Information Management Office, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan.
⁹ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan. Electronic address: jlfuh@vghtpe.gov.tw.

PMID: 40449827
DOI: 10.1016/j.jdent.2025.105862

Oral health variables associated with factors across the Alzheimer's disease continuum: from subjective cognitive decline to dementia

Shih-Yun Wu et al. J Dent. 2025 Sep.

. 2025 Sep:160:105862.

doi: 10.1016/j.jdent.2025.105862. Epub 2025 May 29.

Authors

Shih-Yun Wu¹, Ching-Yi Wu², Yung-Shuan Lin³, Chia-Shu Lin⁴, Wei-Ju Lee⁵, Ssu-Jung He⁶, Guo-Hao Lin⁷, Hsin-Yi Huang⁸, Jong-Ling Fuh⁹

Affiliations

¹ Department of Stomatology, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan; College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Department of Orofacial Sciences, School of Dentistry, University of California, No. 707 Parnassus Ave, San Francisco, CA, 94143, USA.
² Institute of Oral Biology, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan.
³ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan.
⁴ College of Dentistry, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Oral Medicine Innovation Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan.
⁵ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Neurological Institute, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sect. 4, Taichung, 407219, Taiwan; Dementia Center, Taichung Veterans General Hospital, No. 1650 Taiwan Boulevard Sect. 4, Taichung, 407219, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, No. 145 Xingda Rd., South Dist., Taichung City 402202, Taiwan.
⁶ Department of Stomatology, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan.
⁷ Department of Orofacial Sciences, School of Dentistry, University of California, No. 707 Parnassus Ave, San Francisco, CA, 94143, USA.
⁸ Information Management Office, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan.
⁹ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Shi-Pai Road Section 2, Taipei, 11217 Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, No. 155, Section 2, Linong Street, Taipei, 11221, Taiwan. Electronic address: jlfuh@vghtpe.gov.tw.

PMID: 40449827
DOI: 10.1016/j.jdent.2025.105862

Abstract

Objective: This study in Taiwan examined the association between oral health factors and cognitive decline in Alzheimer's disease (AD) continuum, including subjective cognitive decline (SCD).

Methods: Eighty-one participants aged 60 and older were recruited and divided into four groups: control, SCD, mild cognitive impairment (MCI), and AD. Oral health parameters, including number of missing teeth, masticatory performance, occlusal support (Eichner index), and periodontal status, were evaluated through clinical examinations. Cognitive function was assessed using Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Logistic regression analyzed associations between oral health and dementia severity, while ordered logistic regression evaluated the impact of oral health on dementia progression. A two-way ANOVA assessed variations in cognitive scores across diagnostic categories and Eichner index classifications.

Results: Adjusted odds ratios (OR_adj) for natural tooth loss (>14 teeth lost versus 1-13 teeth lost) were 1.45, 4.69, and 10.18 times for the SCD, MCI, and AD groups, respectively, in comparison to the control group. Unrestored teeth after fixed prostheses and the loss of occlusal supportive zones were strongly associated with MCI and AD. Participants with SCD in Eichner categories B and C had lower MoCA scores than those in category A, although no similar trend was observed in the MMSE.

Conclusions: The findings suggest that maintaining occlusal support may help mitigate cognitive decline.

Clinical significance: "Unrestored teeth and loss of occlusal support were linked to cognitive decline." These findings underscore the clinical relevance of routine oral assessments and timely prosthetic rehabilitation in mitigating cognitive decline.

Keywords: Alzheimer's disease; Dementia; Occlusal support; Subjective cognitive decline.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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Oral health variables associated with factors across the Alzheimer's disease continuum: from subjective cognitive decline to dementia

Affiliations

Oral health variables associated with factors across the Alzheimer's disease continuum: from subjective cognitive decline to dementia

Authors

Affiliations

Abstract

Conflict of interest statement

MeSH terms

LinkOut - more resources

Full Text Sources

Medical