Abstract
OBJECTIVES: This study examines the mediating role of nutritional intake in the relationship between tooth loss and healthy ageing in older American adults. METHODS: A secondary data analysis was conducted using the Health and Retirement Study (HRS), a longitudinal survey of American older adults aged 50 years and over. Data from six waves from 2006 to 2016 were used. Nutritional intake was assessed in 2013 using ten essential nutrients, categorised as adequate or inadequate based on national dietary recommendations. Healthy ageing was an aggregate variable composed of freedom from cognitive impairment, freedom from disability, and high physical functioning. Tooth loss was measured as a dichotomous variable (edentate/dentate). Structural equation modelling was used to assess the associations between tooth loss in 2012, nutrition in 2013, and healthy ageing in 2016, accounting for demographic/socioeconomic factors and behaviours. RESULTS: A total of 3665 participants were included on the analysis. A significant association was found between being dentate in 2012 and nutritional intake in 2013 (coefficient 0.63: 95% CI: 0.62, 0.54, p < 0.001). Healthy ageing in 2016 was significantly influenced by socioeconomic factors in 2006 (coefficient 0.84: 95% CI: 1.38, 1.42, p < 0.001) and nutrition in 2013 (coefficient 0.05: 95% CI: 0.04, 0.05, p < 0.001). Non-Black individuals showed a significant association with healthy ageing. CONCLUSIONS: The findings underscore the complex interplay of nutrition, socioeconomic status, health behaviours, and oral health in predicting healthy ageing trajectories. This study highlights the importance of oral health to maintaining adequate nutritional intake, which in turn promotes healthy ageing.