Perceived Masticatory Function and Mortality: A Causal Study

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Masticatory function is crucial for overall health and may impact longevity.
• Declining chewing ability is a growing concern among aging populations worldwide.
• Public health interventions targeting masticatory function could potentially improve health outcomes.

Purpose of the Study:

• To determine the association between perceived masticatory function and all-cause mortality in older adults.
• To quantify the causal impact of perceived masticatory function on all-cause mortality using advanced statistical methods.
• To explore the potential benefits of preserving masticatory function for extending lifespan.

Main Methods:

• Utilized data from a nationally representative longitudinal study of older adults in Singapore.
• Perceived masticatory function was assessed as a time-varying exposure across six difficulty levels.
• Employed multivariable Cox regression and a doubly robust causal inference approach (longitudinal modified treatment policies) for analysis.

Main Results:

• Each one-level decrease in perceived masticatory function was associated with a 9% increase in the hazard ratio for all-cause mortality (HR=1.09).
• Individuals with any level of chewing difficulty (vs. no difficulty) had a 25% higher hazard ratio for all-cause mortality (HR=1.25).
• A hypothetical scenario preserving maximum masticatory function for all participants showed a 3% increase in survival probability over 6 years.

Conclusions:

• Increased perceived masticatory function is significantly associated with and causally linked to reduced all-cause mortality in older Asian adults.
• Interventions aimed at preserving or improving chewing ability may contribute to longer life spans and improved healthy life expectancy in the elderly.
• Masticatory function represents a modifiable factor with potential public health implications for aging populations.