ArticleBMC oral health2025
The mediating role of cognitive function in the association between tooth loss and depressive symptoms: a cross-sectional study.
Article in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Interplay of depressive symptoms and clinical oral health conditions: a systematic review and meta-analysis.Brazilian oral research · 2026Pooled it
- Edentulism and incident hip fracture among middle-aged and older adults in China: evidence from the CHARLS.BMC public health · 2026Article
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6 authors.
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Abstract
backgroundDepression is a significant health concern among the aging population, and prior research suggests edentulism as a risk factor for depression. However, the specific mechanisms linking edentulism and depression are not fully understood.
objectivesThis study aimed to investigate the complex interrelationships between tooth loss, cognitive function, and depressive symptoms in middle-aged and older adults. We specifically sought to determine if cognitive function mediates the association between tooth loss and depression.
methodsThis study performed a secondary analysis of cross-sectional data from the 2018 wave of the China Health and Retirement Longitudinal Study (CHARLS), with a mean age of 60.8 years (47% women, 53% men). Depressive symptoms, the binary outcome variable, were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10). Tooth loss was measured by self-report and categorized as a binary variable (complete tooth loss vs. not). Cognitive function, encompassing orientation, memory, calculation, and visuospatial skills, served as the mediate variable. Causal mediation analysis was performed to estimate the mediating role of cognitive function.
resultsThe final analysis included 11,000 participants. Univariate analysis showed a significant association between tooth loss and depression, which remained significant across all three multivariate logistic regression models. Causal mediation analysis indicated that the average causal mediation effect (ACME) of global cognitive ability on the association between tooth loss and depression was 0.043 (95% CI: 0.037, 0.050). The average direct effect (ADE) of tooth loss on depression was 0.024 (95% CI: 0.001, 0.050). Global cognitive ability mediated 61.6% of the total effect (95% CI: 0.439, 0.987).
conclusionIn this nationally representative cohort, complete tooth loss was associated with a higher prevalence of depression, with cognitive impairment accounting for a substantial proportion of this association. This is the first study to quantify the mediating role of cognition in this pathway.
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