Edentulism, blood-based neurodegenerative biomarkers, and 10-year dementia risk: A mediation analysis in a nationally representative United States cohort.

Authors

Xiang Qi, Ruotong Liu, Daniel W Belsky, Qu Tian, Huabin Luo, Yunrui Liu, Zhijing Xu, Kenneth M Langa, Bei Wu

Published in

Alzheimer's & dementia : the journal of the Alzheimer's Association. Volume 22. Issue 8. Pages e71731.

Abstract

Tooth loss is associated with dementia risk, but mechanisms remain unclear. We examined whether blood-based neurodegenerative biomarkers mediate the edentulism-cognition association.
Among 4238 Health and Retirement Study participants aged 50+, we linked edentulism (2012), biomarkers (neurofilament light chain [NfL], glial fibrillary acidic protein [GFAP], phosphorylated tau-181, and amyloid-β [Aβ] 42/40; 2016), and 10-year cognitive outcomes (2012-2022).
Edentulism was associated with higher NfL (β = 4.21) and GFAP (β = 8.06), but not pTau-181 or Aβ42/40, and predicted cognitive impairment (hazard ratio [HR] 1.49) and dementia (HR 1.28). GFAP mediated 9.8% and 12.0% of the cognitive impairment and dementia associations, respectively; NfL mediated 9.8% of the dementia association but not cognitive impairment.
In this observational cohort, elevated NfL and GFAP were associated with, and accounted for a small proportion of, the edentulism-cognition association. These associative findings support further study of oral health in dementia prevention but do not establish a causal effect.

PMID:
42555275
Bibliographic data and abstract were imported from PubMed on 06 Aug 2026.

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