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As this issue is not commonly addressed in dental studies, it is the aim of this study to examine the consequences of attrition with respect to tooth loss and mortality in a 10-y follow-up study. From the Study of Health in Pomerania (SHIP-0), a biological age (BA) score was constructed from 10 systemic biomarkers and related to one\u2019s actual chronological age (CA). The 3,417 dentate participants were stratified according to their BA-CA scores into tertiles: individuals with younger BA than their CA, those with concurrent BA and CA, and those with older BA than their CA. Baseline characteristics and propensity of leaving or remaining in the study were compared across these tertiles. We compared the characteristics within BA strata in the remainers of SHIP-2 (10-y follow-up) and their impact on tooth loss. Besides dropout by those who died, the attrition propensity of baseline study participants was dose dependent as related to BA-CA scores and socioeconomic factors. BA younger participants were underrepresented in dropouts but overrepresented in remaining follow-up participants. BA younger participants had a more favorable risk profile, better oral health, and a lower mortality rate than BA older participants. For the BA older participants, the opposite was observed. Remainers attaining the follow-up SHIP-2 were healthier and more health conscious. After 10 y, their tooth retention was still directed by BA constructed at baseline. The results support the assumption that individual risk profiles aggregated in BA constitute characteristic susceptibility patterns affecting perseverance or attrition in long-term follow-up studies. Attrition, which is common to follow-up studies, changes the study composition of participants depending on their BA and hence the transferability of results to the baseline population. The baseline BA gradient persists even after a long time.<\/jats:p>","DOI":"10.1177\/00220345241294006","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:22:28Z","timestamp":1733444548000},"page":"204-210","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Biological Age Affecting Attrition and Tooth Loss in a Follow-up Study"],"prefix":"10.1177","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-2435","authenticated-orcid":false,"given":"P.","family":"Meisel","sequence":"first","affiliation":[{"name":"Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Pink","sequence":"additional","affiliation":[{"name":"Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"D\u00f6rr","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Nauck","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Diagnostics, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"V\u00f6lzke","sequence":"additional","affiliation":[{"name":"Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Kocher","sequence":"additional","affiliation":[{"name":"Dental Clinics, Department of Periodontology, University Medicine Greifswald, Greifswald, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"issue":"1","key":"e_1_3_2_2_1","first-page":"103","article-title":"Comparison of salivary IGF-1, IGFBP-3, and CTX with periodontal status among patients belonging to various skeletal maturity groups","volume":"20","author":"Almalki A","year":"2022","unstructured":"Almalki A, Thomas JT, Salama MH, Alghamdi SA, Almulhim B, Alassaf A, Joseph B, Alqerban A. 2022. 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