{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:28:38Z","timestamp":1789741718468,"version":"4.0.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["15H01972"],"award-info":[{"award-number":["15H01972"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["18H03047"],"award-info":[{"award-number":["18H03047"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19H03860"],"award-info":[{"award-number":["19H03860"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19H03861"],"award-info":[{"award-number":["19H03861"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["20H00557"],"award-info":[{"award-number":["20H00557"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["21H03153"],"award-info":[{"award-number":["21H03153"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Labour Sciences Research Grant","award":["H28-Choju-Ippan-002"],"award-info":[{"award-number":["H28-Choju-Ippan-002"]}]},{"name":"Health Labour Sciences Research Grant","award":["19FA1012"],"award-info":[{"award-number":["19FA1012"]}]},{"name":"Health Labour Sciences Research Grant","award":["19FA2001"],"award-info":[{"award-number":["19FA2001"]}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP18dk0110027"],"award-info":[{"award-number":["JP18dk0110027"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP18ls0110002"],"award-info":[{"award-number":["JP18ls0110002"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP18le0110009"],"award-info":[{"award-number":["JP18le0110009"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP20dk0110034"],"award-info":[{"award-number":["JP20dk0110034"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP21lk0310073"],"award-info":[{"award-number":["JP21lk0310073"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP21dk0110037"],"award-info":[{"award-number":["JP21dk0110037"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Open Innovation Platform with Enterprises"},{"name":"Research Institute and Academia","award":["JPMJOP1831"],"award-info":[{"award-number":["JPMJOP1831"]}]},{"name":"Innovative Research Program on Suicide Countermeasures","award":["1\u20134"],"award-info":[{"award-number":["1\u20134"]}]},{"name":"FUTOKU"},{"name":"Research Funding for Longevity Sciences","award":["29\u201342"],"award-info":[{"award-number":["29\u201342"]}]},{"DOI":"10.13039\/501100007312","name":"National Center for Geriatrics and Gerontology","doi-asserted-by":"publisher","award":["29\u201342"],"award-info":[{"award-number":["29\u201342"]}],"id":[{"id":"10.13039\/501100007312","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,1,26]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Oral diseases are preventable and modifiable, but highly prevalent, and cause worse oral status. Particularly, tooth loss has increased in aging societies. However, studies on population-attributable risks of modifiable risk factors for mortality have neglected oral status. This study aimed to investigate the impact of modifiable risk factors on mortality, including oral status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cohort study used the Japan Gerontological Evaluation Study data, including participants aged \u226565 years. The outcome was death between August 2010 and March 2017. We calculated the hazard ratios (HRs) and population attributable fraction (PAF) of modifiable risk factors (oral status, hypertension, depression, heart disease, diabetes, physical activity, smoking status, and alcohol drinking history) for mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analyses included 24 175 men and 27 888 women (mean age: 73.8 [6.0] and 74.2 [6.1], respectively). In men, after adjusting for covariates, having no teeth showed the highest hazard ratio (HR = 1.67, 95% confidence interval [CI] = 1.51\u20131.86) among the modifiable risk factors, and the PAF for the number of teeth (18.2%) was the second largest following age. In women, having no teeth had the third largest HR (HR = 1.37, 95% CI = 1.19\u20131.56) following current and former smoking. The PAF for the number of teeth (8.5%) was the sixth largest, which was larger than that of smoking status (4.8%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the older population, the HR and PAF of the number of teeth on mortality were sufficiently large compared with other modifiable risk factors, especially in men. Therefore, maintaining good oral status should be included more in global health policies.<\/jats:p><\/jats:sec>","DOI":"10.1093\/gerona\/glac052","type":"journal-article","created":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T17:30:33Z","timestamp":1646155833000},"page":"167-173","source":"Crossref","is-referenced-by-count":24,"title":["Large Contribution of Oral Status for Death Among Modifiable Risk Factors in Older Adults: The Japan Gerontological Evaluation Study (JAGES) Prospective Cohort Study"],"prefix":"10.1093","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7743-8383","authenticated-orcid":false,"given":"Noriko","family":"Nakazawa","sequence":"first","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry , Miyagi , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8683-4484","authenticated-orcid":false,"given":"Taro","family":"Kusama","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry , Miyagi , Japan"},{"name":"Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University , Miyagi , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upul","family":"Cooray","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry , Miyagi , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takafumi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry , Miyagi , Japan"},{"name":"Department of Health Promotion, National Institute of Public Health , Saitama , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8298-8643","authenticated-orcid":false,"given":"Sakura","family":"Kiuchi","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry , Miyagi , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hazem","family":"Abbas","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry , Miyagi , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Dental Sociology, Kanagawa Dental University , Kanagawa , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsunori","family":"Kondo","sequence":"additional","affiliation":[{"name":"Center for Preventive Medical Sciences, Chiba University , Chiba , Japan"},{"name":"Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology , Aichi , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Osaka","sequence":"additional","affiliation":[{"name":"Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry , Miyagi , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8405-9872","authenticated-orcid":false,"given":"Jun","family":"Aida","sequence":"additional","affiliation":[{"name":"Division for Regional Community Development, Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University , Miyagi , Japan"},{"name":"Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo , Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,3,1]]},"reference":[{"key":"2023012703133840900_CIT0001","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/S0140-6736(21)01404-5","article-title":"The WHO global strategy for oral health: an opportunity for bold action","volume":"398","author":"Benzian","year":"2021","journal-title":"Lancet."},{"issue":"10194","key":"2023012703133840900_CIT0002","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S0140-6736(19)31146-8","article-title":"Oral diseases: a global public health challenge","volume":"394","author":"Peres","year":"2019","journal-title":"Lancet."},{"issue":"10226","key":"2023012703133840900_CIT0003","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/S0140-6736(19)32008-2","article-title":"Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study","volume":"395","author":"Yusuf","year":"2020","journal-title":"Lancet."},{"issue":"1","key":"2023012703133840900_CIT0004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41598-020-61127-7","article-title":"Modifiable risk factors for 9-year mortality in older English and Brazilian adults: the ELSA and SIGa-Bag\u00e9 ageing cohorts","volume":"10","author":"Kessler","year":"2020","journal-title":"Sci Rep."},{"issue":"1","key":"2023012703133840900_CIT0005","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1093\/ije\/dyz078","article-title":"Smoking, drinking, diet and physical activity\u2015Modifiable lifestyle risk factors and their associations with age to first chronic disease","volume":"49","author":"Ng","year":"2020","journal-title":"Int J Epidemiol."},{"issue":"3","key":"2023012703133840900_CIT0006","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1016\/j.amepre.2016.09.036","article-title":"Cigarette smoking and mortality in adults aged 70 Years and older: results from the NIH-AARP Cohort","volume":"52","author":"Nash","year":"2017","journal-title":"Am J Prev Med."},{"issue":"4","key":"2023012703133840900_CIT0007","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1017\/S0007114517000435","article-title":"Malnutrition is associated with increased mortality in older adults regardless of the cause of death","volume":"117","author":"S\u00f6derstr\u00f6m","year":"2017","journal-title":"Br J Nutr."},{"issue":"4","key":"2023012703133840900_CIT0008","doi-asserted-by":"crossref","first-page":"875","DOI":"10.3945\/ajcn.113.068122","article-title":"BMI and all-cause mortality in older adults: a meta-analysis","volume":"99","author":"Winter","year":"2014","journal-title":"Am J Clin Nutr."},{"issue":"1","key":"2023012703133840900_CIT0009","first-page":"4","article-title":"Global, regional, and national levels and trends in burden of oral conditions from 1990 to 2017: a systematic analysis for the global burden of disease 2017 study","volume":"7","author":"Bernabe","year":"2022","journal-title":"J Dent Res."},{"key":"2023012703133840900_CIT0010","article-title":"Tooth loss and nutritional status in older adults: a systematic review and meta-analysis","author":"Zelig","year":"2020","journal-title":"JDR Clin Transl Res"},{"key":"2023012703133840900_CIT0011","doi-asserted-by":"crossref","first-page":"e02992929929","DOI":"10.1136\/bmjopen-2019-029929","article-title":"Association between the number of teeth and frailty among Chinese older adults: a nationwide cross-sectional study","volume":"9","author":"Gu","year":"2019","journal-title":"BMJ Open."},{"issue":"1","key":"2023012703133840900_CIT0012","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1042\/BSR20181773","article-title":"The relationship between tooth loss and mortality from all causes, cardiovascular diseases, and coronary heart disease in the general population: systematic review and dose\u2013response meta-analysis of prospective cohort studies","volume":"39","author":"Peng","year":"2019","journal-title":"Biosci Rep."},{"issue":"12","key":"2023012703133840900_CIT0013","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1093\/gerona\/glx225","article-title":"Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly","volume":"73","author":"Tanaka","year":"2018","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2023012703133840900_CIT0014","article-title":"Oral disorders\u2014Level 3 cause","volume-title":"Lancet","author":"The Institute for Health Metrics and Evaluation (IHME)."},{"key":"2023012703133840900_CIT0015","volume-title":"Advancing Universal Health Coverage through Knowledge Translation for Healthy Ageing: Lessons Learnt from the Japan Gerontological Evaluation Study","author":"Kondo","year":"2018"},{"issue":"3","key":"2023012703133840900_CIT0016","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1111\/ger.12406","article-title":"Association between oral health and frailty: a systematic review of longitudinal studies","volume":"36","author":"Hakeem","year":"2019","journal-title":"Gerodontology."},{"issue":"7","key":"2023012703133840900_CIT0017","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2468-2667(18)30091-4","article-title":"Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK Biobank participants","volume":"3","author":"Hanlon","year":"2018","journal-title":"Lancet Public Health."},{"issue":"4","key":"2023012703133840900_CIT0018","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1111\/ggi.12397","article-title":"English translation of the Kihon checklist","volume":"15","author":"Arai","year":"2015","journal-title":"Geriatr Gerontol Int."},{"issue":"3","key":"2023012703133840900_CIT0019","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1177\/089198879100400310","article-title":"The short form of the Geriatric Depression Scale: a comparison with the 30-item form","volume":"4","author":"Burke","year":"1991","journal-title":"J Geriatr Psychiatry Neurol."},{"issue":"12","key":"2023012703133840900_CIT0020","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1038\/sj.bdj.4801461","article-title":"The relationship between oral health status and Body Mass Index among older people: a national survey of older people in Great Britain","volume":"192","author":"Sheiham","year":"2002","journal-title":"Br Dent J."},{"issue":"11","key":"2023012703133840900_CIT0021","doi-asserted-by":"crossref","first-page":"497","DOI":"10.2188\/jea.JE20190083","article-title":"Gender difference in the association between subjective socioeconomic mobility across life course and mortality at older ages: results from the JAGES longitudinal study","volume":"30","author":"Nagamine","year":"2019","journal-title":"J Epidemiol."},{"issue":"2","key":"2023012703133840900_CIT0022","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1111\/ger.12319","article-title":"Hyposalivation and 10-year all-cause mortality in an elderly Japanese population","volume":"35","author":"Iwasaki","year":"2018","journal-title":"Gerodontology."},{"issue":"8","key":"2023012703133840900_CIT0023","doi-asserted-by":"crossref","first-page":"971","DOI":"10.1016\/j.jamda.2019.01.155","article-title":"Cohort study on laryngeal cough reflex, respiratory disease, and death: a Mediation Analysis","volume":"20","author":"Yamamoto","year":"2019","journal-title":"J Am Med Dir Assoc."},{"issue":"12","key":"2023012703133840900_CIT0024","doi-asserted-by":"crossref","first-page":"2503","DOI":"10.1111\/jgs.14331","article-title":"Self-reported masticatory dysfunction and mortality in community dwelling elderly adults: a 9-year follow-up","volume":"64","author":"Laudisio","year":"2016","journal-title":"J Am Geriatr Soc."},{"issue":"2","key":"2023012703133840900_CIT0025","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1177\/1745691614568352","article-title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","volume":"10","author":"Holt-Lunstad","year":"2015","journal-title":"Perspect Psychol Sci J Assoc Psychol Sci."},{"issue":"2","key":"2023012703133840900_CIT0026","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1136\/jech-2020-214545","article-title":"Associations between vision, hearing and tooth loss and social interactions: the JAGES cross-sectional study","volume":"75","author":"Igarashi","year":"2021","journal-title":"J Epidemiol Community Health."},{"key":"2023012703133840900_CIT0027","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.arr.2015.04.006","article-title":"Social relationships and risk of dementia: a systematic review and meta-analysis of longitudinal cohort studies","volume":"22","author":"Kuiper","year":"2015","journal-title":"Ageing Res Rev."},{"issue":"1","key":"2023012703133840900_CIT0028","doi-asserted-by":"crossref","first-page":"e12200","DOI":"10.1002\/trc2.12200","article-title":"Global mortality from dementia: application of a new method and results from the Global Burden of Disease Study 2019","volume":"7","author":"GBD. 2019 Collaborators.","year":"2021","journal-title":"Alzheimer\u2019s Dement"},{"issue":"1","key":"2023012703133840900_CIT0029","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.bj.2018.12.001","article-title":"Association between periodontal pathogens and systemic disease","volume":"42","author":"Bui","year":"2019","journal-title":"Biomed J."},{"key":"2023012703133840900_CIT0030","author":"World Health Organization 2018.","year":"2018"},{"key":"2023012703133840900_CIT0031","article-title":"Ministry of Health Labour and Welfare","year":"2020"},{"issue":"10022","key":"2023012703133840900_CIT0032","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/S0140-6736(15)01225-8","article-title":"Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis","volume":"387","author":"Ettehad","year":"2016","journal-title":"Lancet."},{"issue":"9","key":"2023012703133840900_CIT0033","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1038\/s41440-019-0284-9","article-title":"The Japanese society of hypertension guidelines for the management of hypertension (JSH 2019)","volume":"42","author":"Umemura","year":"2019","journal-title":"Hypertens Res."},{"issue":"6","key":"2023012703133840900_CIT0034","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1093\/gerona\/glp012","article-title":"Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries","volume":"64","author":"Santos-Eggimann","year":"2009","journal-title":"J Gerontol A Biol Sci Med Sci."}],"container-title":["The Journals of Gerontology: Series A"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/advance-article-pdf\/doi\/10.1093\/gerona\/glac052\/43377403\/glac052.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/article-pdf\/78\/1\/167\/48909934\/glac052.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/article-pdf\/78\/1\/167\/48909934\/glac052.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,19]],"date-time":"2024-09-19T15:52:44Z","timestamp":1726761164000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/article\/78\/1\/167\/6540475"}},"subtitle":[],"editor":[{"given":"Roger","family":"Fielding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,3,1]]},"references-count":34,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,3,1]]},"published-print":{"date-parts":[[2023,1,26]]}},"URL":"https:\/\/doi.org\/10.1093\/gerona\/glac052","relation":{},"ISSN":["1079-5006","1758-535X"],"issn-type":[{"value":"1079-5006","type":"print"},{"value":"1758-535X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,1,1]]},"published":{"date-parts":[[2022,3,1]]}}}