Chewing difficulty, swallowing problems, xerostomia and cause-specific mortality among older adults: A 7-year follow-up JAGES cohort study.

AIM: Although various poor oral health conditions have been reported to be associated with an increased all-cause mortality risk, a comprehensive investigation of the causes of death is limited. This study aimed to investigate the association between poor oral function and mortality due to various causes in older adults.

METHODS

This 7-year follow-up cohort study used data from the Japan Gerontological Evaluation Study. The participants were independent older adults aged ≥65 years at baseline. The outcome and exposure variables were 10 types of cause-specific mortality and poor oral functioning (chewing difficulty, swallowing problems and xerostomia). Cause-specific hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using the Cox proportional hazards model.

RESULTS

Among the 44 083 participants (mean age 73.7 years [SD 6.0], men 46.8%), the all-cause mortality was 20.76 per 1000 person-years. After considering all covariates, chewing difficulty was significantly associated with high mortality risk due to neoplasms (HR 1.18, 95% CI 1.07-1.30) and circulatory diseases (HR 1.15, 95% CI 1.01-1.31), swallowing problems was significantly associated with high mortality risk due to nervous system diseases (HR 2.84, 95% CI 1.80-4.47) and respiratory diseases (HR 1.42, 95% CI 1.20-1.70), and xerostomia was significantly associated with high mortality risk due to nervous system diseases (HR 1.87, 95% CI 1.20-2.92), circulatory diseases (HR 1.20, 95% CI 1.06-1.37) and respiratory diseases (HR 1.35, 95% CI 1.16-1.58), respectively.

CONCLUSIONS

The present results suggest that poor oral functioning, including chewing difficulty, swallowing problems and xerostomia, could amplify the risk of mortality due to specific diseases. Dental and medical professionals should pay more attention to older adults with poor oral function to prevent subsequent critical health issues. Geriatr Gerontol Int 2025; 25: 1332-1340.