{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:53:46Z","timestamp":1790924026160,"version":"4.1.0"},"reference-count":47,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["NO.72074168; NO.72304210"],"award-info":[{"award-number":["NO.72074168; NO.72304210"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Project for the Promotion and Optimization of Diagnostic and Therapeutic Technologies in Municipal Hospitals, Shanghai Shenkang Hospital Development Center","award":["SHDC22024207"],"award-info":[{"award-number":["SHDC22024207"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Edentulism has been linked to cognitive decline, yet its effects on the transitions from normal cognition to dementia and ultimately death remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate how edentulism influences cognitive state transitions across the aging continuum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective cohort analysis of 22,205 adults aged 50 years or older from China, the USA, and England, with cognitive states assessed over a median follow-up of 12.3 years. Multi-state Markov models were used to estimate transition-specific hazard ratios (HR) and population attributable fractions (PAFs) for edentulism after adjusting for sociodemographic, behavioral, and health covariates. A Cox regression model was used to estimate edentulism associated with the risk of cognitive status and death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At baseline, 7.41% of Chinese, 21.64% of US, and 14.24% of English participants were edentulous. During follow-up, 60.1% developed mild cognitive impairment (MCI), 13.6% of those progressed to dementia, and 36.0% died after dementia. Edentulism significantly increased the risk of transition from baseline to death (HR\u2009=\u20091.27, 95% CI:1.13, 1.42) and from MCI to dementia (HR\u2009=\u20091.26, 95% CI:1.12, 1.40). The corresponding PAFs were 4.58% and 6.52%, respectively. Subgroup analyses by age and sex yielded consistent results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Edentulism was associated with faster progression from MCI to dementia and higher death risk. These findings highlight the importance of oral health maintenance as a potential target for Alzheimer's disease and dementia prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/13872877261487358","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:05:41Z","timestamp":1790604341000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Edentulism and cognitive transitions: A multi-state analysis"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0214-1491","authenticated-orcid":false,"given":"Lulu","family":"Tang","sequence":"first","affiliation":[{"name":"Shanghai Tenth People's Hospital"},{"name":"Tongji University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2401-3474","authenticated-orcid":false,"given":"Changcui","family":"Qiu","sequence":"additional","affiliation":[{"name":"Shanghai Tenth People's Hospital"},{"name":"Tongji University School of Medicine, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7894-7909","authenticated-orcid":false,"given":"Chunwei","family":"Chi","sequence":"additional","affiliation":[{"name":"Shanghai Tenth People's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9333-8931","authenticated-orcid":false,"given":"Fei","family":"Liu","sequence":"additional","affiliation":[{"name":"Shanghai Tenth People's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7515-2277","authenticated-orcid":false,"given":"Xiaoping","family":"Zhu","sequence":"additional","affiliation":[{"name":"Shanghai Tenth People's Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"GBD 2019 Dementia Forecasting Collaborators. 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Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040: modelling study. 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