{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T03:46:20Z","timestamp":1789962380467,"version":"4.0.1"},"reference-count":54,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T00:00:00Z","timestamp":1611619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["19K19309"],"award-info":[{"award-number":["19K19309"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Tooth loss is associated with reduced functional capacity, but so far, there is no relevant causal evidence reported. We investigated the causal effect of tooth loss on the instrumental activities of daily living (IADL) among older adults in England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Natural experiment study with instrumental variable analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The English Longitudinal Study of Aging (ELSA) combined with the participants' childhood exposure to water fluoride due to the community water fluoridation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Five thousand six hundred and thirty one adults in England born in 1945\u20131965 participated in the ELSA wave seven survey (conducted in 2014\u20132015; average age: 61.0\u2009years, 44.6% men).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The number of natural teeth predicted by the exogenous geographical and historical variation in exposure to water fluoride from age 5 to 20\u2009years old (instrumental variable) was used as an exposure variable. The outcome, having any limitations in IADL (preparing a hot meal, shopping for groceries, making telephone calls, taking medications, doing work around the house or garden, or managing money), was assessed by self\u2010reported questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Linear probability model with Two\u2010Stage Least Squares estimation was fitted. Being exposed to fluoridated water was associated with having more natural teeth in later life (coefficient: 0.726; 95% confidence interval (CI) = 0.311, 1.142;\n                      <jats:italic>F<\/jats:italic>\n                      = 11.749). Retaining one more natural tooth reduced the probability of having a limitation in IADL by 3.1 percentage points (coefficient: \u22120.031; 95% CI = \u22120.060, \u22120.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preventing tooth loss maintains functional capacity among older adults in England. Given the high prevalence of tooth loss, this effect is considerable. Further research on the mechanism of the observed causal relationship is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.17021","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T07:36:40Z","timestamp":1611646600000},"page":"1319-1327","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Causal Effect of Tooth Loss on Functional Capacity in Older Adults in England: A Natural Experiment"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6114-5604","authenticated-orcid":false,"given":"Yusuke","family":"Matsuyama","sequence":"first","affiliation":[{"name":"Department of Global Health Promotion Tokyo Medical and Dental University (TMDU)  Bunkyo\u2010ku Japan"},{"name":"Japan Society for the Promotion of Science  Tokyo Japan"},{"name":"Department of Epidemiology and Public Health University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Listl","sequence":"additional","affiliation":[{"name":"Department of Dentistry \u2010 Quality and Safety of Oral Healthcare Radboud University Medical Center  Nijmegen The Netherlands"},{"name":"Department of Conservative Dentistry Translational Health Economics Group, Heidelberg University  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"J\u00fcrges","sequence":"additional","affiliation":[{"name":"Schumpeter School of Business and Economics University of Wuppertal  Wuppertal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard G.","family":"Watt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Aida","sequence":"additional","affiliation":[{"name":"Department of Oral Health Promotion Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University  Tokyo Japan"},{"name":"Division for Regional Community Development Liaison Center for Innovative Dentistry, Graduate School of Dentistry, Tohoku University  Sendai Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Tsakos","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health University College London  London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/arclin\/acw049"},{"key":"e_1_2_6_3_1","first-page":"122","volume-title":"Research, Planning, and Action for the Elderly: The Power and Potential of Social Science","author":"Lawton M","year":"1972"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01499.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/gly024"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa020614"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034517713166"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01602.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.14324"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.13190"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/00220345010800020201"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000085086.50957.22"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2014-205345"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034516657992"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40496-017-0121-7"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.301918"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12246"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12332"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glt189"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1614394"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12231"},{"key":"e_1_2_6_22_1","unstructured":"The British Fluoridation Society. 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