Edentulism, social mobility, and cognitive aging: a life course perspective.

Although edentulism and social mobility have each been linked to cognitive decline, few studies have examined their joint effects or how these relationships vary across age groups. This study investigated the independent and joint effects of edentulism and intergenerational social mobility on cognitive function, with a focus on age-specific patterns.We analyzed data from the Health and Retirement Study (2006-2020), including 23,158 adults aged 51+. Cognitive function was assessed using a 27-point modified Telephone Interview for Cognitive Status. Social mobility was measured using intergenerational education mobility, and edentulism was determined through self-reporting. Linear mixed-effects models with lagged time-varying covariates were used to assess longitudinal cognitive trajectories.At baseline, 13.2% of participants were edentulous. Social mobility categories included stable low socioeconomic position (SEP) (29.6%), stable medium/high SEP (34.3%), upward mobility (17.1%), and downward mobility (19.1%). Edentulism was associated with lower baseline cognitive function and faster decline. All non-low-SEP groups had significantly higher baseline cognition, with the stable medium/high SEP group also showing slower cognitive decline and greater resilience against the negative effects of edentulism over time. Interactive effects between edentulism and social mobility were most pronounced among adults aged 65-74. Among those aged 75+, neither edentulism nor social mobility significantly affected cognitive outcomes.Edentulism and social mobility independently and interactively influence cognitive aging, particularly in adults aged 51-74. Findings highlight the importance of addressing oral health disparities and social determinants of health at an early age to support cognitive health across diverse SEPs.

Duke Scholars

Author Bei Wu School of Nursing