{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:54:24Z","timestamp":1790902464941,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency","doi-asserted-by":"publisher","award":["JPMJSP2108"],"award-info":[{"award-number":["JPMJSP2108"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AG042463"],"award-info":[{"award-number":["R01AG042463"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Gerodontology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine whether protein intake mediates the association between the number of remaining teeth and functional decline in older Japanese adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Tooth loss has been associated with reduced protein intake and functional decline in older adults. However, whether protein intake mediates this association remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a 6\u2010year longitudinal study using data from a cohort of community\u2010dwelling older adults. Participants aged \u2265\u200965\u2009years were included. Exposure was the number of teeth (\u2265\u200920, 10\u201319, and 0\u20139). The primary outcome was either functional decline or death, and the secondary outcome was weight change. Protein intake was measured using a diet history questionnaire. We used mediation analysis to examine the direct and indirect effects of the number of remaining teeth via protein intake on the outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 1400 eligible participants, the mean ages were 76.3, 76.6, and 78.9\u2009years for groups with \u2265\u200920, 10\u201319, and 0\u20139 teeth, respectively. Protein intake did not mediate the association between the number of teeth and functional decline. In contrast, protein intake showed an indirect association between the number of remaining teeth and weight loss, particularly in individuals with 10\u201319 teeth than those with \u2265\u200920 teeth (indirect effect: \u22120.09% [\u22120.20, \u22120.01]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although protein intake did not mediate the association between the number of remaining teeth and functional decline, it mediated the association between the number of remaining teeth and weight loss. Interventions targeting oral health and protein intake may prevent weight loss in older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ger.70127","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:42:02Z","timestamp":1790851322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mediating Effect of Protein Intake on the Association Between Number of Remaining Teeth and Functional Decline"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6240-5197","authenticated-orcid":false,"given":"Urara","family":"Taguchi","sequence":"first","affiliation":[{"name":"Department of Oral\u2010Maxillofacial Surgery and Orthodontics, Graduate School of Medicine The University of Tokyo  Bunkyo City Tokyo Japan"},{"name":"Department of Nutritional Epidemiology and Behavioural Nutrition, Graduate School of Medicine The University of Tokyo  Bunkyo City Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4378-2578","authenticated-orcid":false,"given":"Sachiko","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Eat\u2010Loss Medicine, Graduate School of Medicine The University of Tokyo  Bunkyo City Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3692-2707","authenticated-orcid":false,"given":"Minami","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Environmental and Occupational Health, School of Medicine Toho University  Ota City Tokyo 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":"Department of Dental Public Health, Graduate School of Medical and Dental Sciences Institute of Science Tokyo  Meguro Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Hikichi","sequence":"additional","affiliation":[{"name":"School of Medicine Kitasato University  Minato City Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Social and Preventive Epidemiology, School of Public Health The University of Tokyo  Bunkyo City Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Kawachi","sequence":"additional","affiliation":[{"name":"Department of Social and Behavioral Science Harvard T. 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Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuto","family":"Hoshi","sequence":"additional","affiliation":[{"name":"Department of Oral\u2010Maxillofacial Surgery and Orthodontics, Graduate School of Medicine The University of Tokyo  Bunkyo City Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"e_1_2_12_2_1","unstructured":"United Nations \u201cWorld Population Prospects \u201d(2019) https:\/\/www.un.org\/development\/desa\/pd\/sites\/www.un.org.development.desa.pd\/files\/undesa_pd_kf_wpp2019_10keyfindings.pdf."},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/61.10.1059"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/advances\/nmab140"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2022.101731"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu10091330"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy192"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqy214"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475\u20102891\u201012\u2010164"},{"key":"e_1_2_12_10_1","unstructured":"\u201cThe Dietary Reference Intakes for Japanese \u201d(2025) https:\/\/www.mhlw.go.jp\/content\/10904750\/001316585.pdf."},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15245113"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13554"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.2186\/jpr.JPR_D_23_00091"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2023.105009"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13784"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.2188\/jea.je20110075"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980018002331"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/1475\u20102891\u201013\u201051"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/geronb\/gbw211"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.12615"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2024.105354"},{"key":"e_1_2_12_22_1","first-page":"3","article-title":"Validation of the Kihon Checklist for Predicting the Risk of 1\u2010Year Incident Long\u2010Term Care Insurance Certification: The Ohsaki Cohort 2006 Study","volume":"58","author":"Tomata Y.","year":"2011","journal-title":"Nihon Koshu Eisei Zasshi"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12397"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102022\u2010071757"},{"key":"e_1_2_12_25_1","volume-title":"Explanation in Causal Inference","author":"Vanderweele T. 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