Edentulism and all-cause mortality among middle-aged and older people in China: A 9-year cohort study

To investigate the association between edentulism and all-cause mortality over a 9-year period and explore how edentulism influences mortality risk in the presence of chronic diseases.

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS), encompassing six waves from 2011 to 2020. Edentulism was assessed via self-reports of 'loss of all natural teeth'. Covariates included demographic status, behavioural factors, and chronic disease history (14 diseases). Kaplan-Meier survival analyses illustrated mortality rates by edentulism status, while Cox proportional hazards models estimated hazard ratios (HRs) for all-cause mortality, adjusting for relevant covariates. Sub analyses explored all-cause mortality risk in the presence of different chronic diseases.

A total of 11,883 individuals of median age 58.8 (IQR 51.9, 66.3) were included in the analyses with 94,648 person-years of follow-up. After adjustment for covariates, edentulism exhibited a higher risk of all-cause mortality over the 9-year period (HR 1.25; 95 % CI, 1.11-1.41). Sub analyses identified that edentulousness was associated with increased mortality risks among patients diagnosed with kidney disease (HR = 1.71; 95 % CI, 1.11-2.65), memory-related diseases (HR = 1.61; 95 % CI, 1.00-2.60), dyslipidemia (HR = 1.70; 95 % CI, 1.13-2.56), heart disease (HR = 1.43; 95 % CI, 1.09-1.87) and arthritis (HR = 1.33; 95 % CI, 1.09-1.62).

Edentulism is associated with an increased risk of all-cause mortality over a 9-year period, having accounted for demographic, behavioural and chronic disease factors. Furthermore, edentulism is associated with an increased mortality risk among several chronic diseases.

The results highlight the importance of considering oral health status in health assessments and mortality risks.