Dental Health and Cognitive Impairment in an English National Survey Population


Address correspondence to Robert Stewart, Section of Epidemiology, Institute of Psychiatry, De Crespigny Park, Box 60, London SE5 8AF, UK. E-mail:


OBJECTIVES: To investigate the association between dental health and cognitive impairment and to examine the extent to which dental status accounts for the association between cognitive impairment and low body mass index (BMI) in a national survey sample.

DESIGN: A secondary analysis of data from the Health Survey for England 2000.

SETTING: A nationally representative cross-sectional population survey.

PARTICIPANTS: Two thousand four hundred sixty-three adults aged 65 and older living in private households and 1,569 adults aged 65 and older living in care homes.

MEASUREMENTS: Data collected by interview (self-reported or by proxy) included age, sex, level of education, disability, BMI, dental status, and cognitive function (Abbreviated Mental Test Score).

RESULTS: Less than half of the community sample (40.4%) and 67.9% of the care home sample were edentulous; lack of teeth was significantly associated with cognitive impairment (odds ratio=3.59, 95% confidence interval=2.36–5.47). This association remained strong after adjustment for other covariates only in the community sample. Cognitive impairment was associated with lower BMI in both samples, but dental status did not explain this.

CONCLUSION: Poor dentition is associated with cognitive impairment. Nutritional status in people with cognitive impairment is recognized to be at risk. Although dental health did not account for the association between cognitive impairment and low BMI in this sample, other possible nutritional consequences require further evaluation.