The journals of gerontology. Series A, Biological sciences and medical sciences · 2026
Differential associations of oral health with early- and late-onset dementia: a prospective analysis of the UK Biobank.
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Liu Yunrui, Qi Xiang, Luo Huabin, Liu Ruotong, Xu Zhijing, Wu Bei
Аннотация
BACKGROUND: Poor oral health is a modifiable risk factor for dementia, but whether the associations differ by age at onset and are modified by genetic susceptibility remains unclear.
METHODS: In this prospective cohort study of 364,231 dementia-free UK Biobank participants, we examined associations between oral health indicators and incident early- and late-onset dementia (EOD and LOD). Genetic susceptibility was assessed using polygenic risk score (PRS) and apolipoprotein E (APOE) ε4 status. Multivariable Cox proportional hazards models evaluated independent and joint associations.
RESULTS: Over a median follow-up of 13.6 years, 359 participants developed EOD and 6,668 developed LOD. Oral health indicators were not consistently associated with EOD. In contrast, painful gums (hazard ratio [HR], 1.24; 95% CI, 1.09-1.40), toothache (HR, 1.17; 95% CI, 1.04-1.33), denture use (HR, 1.18; 95% CI, 1.12-1.25), and a higher number of oral health conditions (HR, 1.08; 95% CI, 1.05-1.12) were consistently associated with increased LOD risk. Joint analyses demonstrated dose-response patterns for LOD, with the highest risks among individuals with both poor oral health and elevated genetic susceptibility.
CONCLUSIONS: Poor oral health was associated primarily with LOD, particularly among individuals with elevated genetic susceptibility.
METHODS: In this prospective cohort study of 364,231 dementia-free UK Biobank participants, we examined associations between oral health indicators and incident early- and late-onset dementia (EOD and LOD). Genetic susceptibility was assessed using polygenic risk score (PRS) and apolipoprotein E (APOE) ε4 status. Multivariable Cox proportional hazards models evaluated independent and joint associations.
RESULTS: Over a median follow-up of 13.6 years, 359 participants developed EOD and 6,668 developed LOD. Oral health indicators were not consistently associated with EOD. In contrast, painful gums (hazard ratio [HR], 1.24; 95% CI, 1.09-1.40), toothache (HR, 1.17; 95% CI, 1.04-1.33), denture use (HR, 1.18; 95% CI, 1.12-1.25), and a higher number of oral health conditions (HR, 1.08; 95% CI, 1.05-1.12) were consistently associated with increased LOD risk. Joint analyses demonstrated dose-response patterns for LOD, with the highest risks among individuals with both poor oral health and elevated genetic susceptibility.
CONCLUSIONS: Poor oral health was associated primarily with LOD, particularly among individuals with elevated genetic susceptibility.