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High-Dimensional Effect Heterogeneity of Tooth Loss on Mortality.

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Tooth loss increases mortality risk in older adults. This risk is higher for men, those with poor health, and lower socioeconomic status, highlighting vulnerable subgroups.

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Area of Science:

  • Gerontology
  • Public Health
  • Epidemiology

Background:

  • Tooth loss is a significant concern for older adults, potentially linked to increased mortality.
  • Understanding the factors influencing this association is crucial for targeted interventions.

Purpose of the Study:

  • To examine the heterogeneity in the association between tooth loss and all-cause mortality among older Japanese adults.
  • To identify subgroups of older adults for whom tooth loss poses a greater mortality risk.

Main Methods:

  • Utilized data from 69,265 Japanese adults aged 65+ from the 2013 Japan Gerontological Evaluation Study.
  • Employed inverse probability weighting and causal forest machine learning to estimate average treatment effects (ATE) and conditional average treatment effects (CATEs).
  • Analyzed 44 covariates including demographic, economic, social, health, and community factors to assess heterogeneity.

Main Results:

  • Tooth loss (<20 natural teeth) was significantly associated with a 3.2 percentage point increase in all-cause mortality risk (ATE = 0.032).
  • Statistically significant heterogeneity was observed, with greater mortality risk associated with tooth loss in men, individuals with poor health, and those with lower socioeconomic status.
  • Heart disease, sex, and depression were identified as key contributors to this heterogeneity.

Conclusions:

  • Tooth loss is a significant indicator of elevated mortality risk in older adults.
  • The magnitude of this risk varies considerably across different population subgroups, particularly affecting vulnerable individuals.
  • Findings underscore the importance of considering oral health as part of comprehensive geriatric care and public health strategies.