The Influence of Age in the Relationship between Cerebral Small Vessel Disease and Edentulism. the Atahualpa Project

Background: The association between edentulism and cerebral small vessel disease is controversial. We aimed to assess this relationship in community-dwelling older adults living in rural Ecuador. Methods: MRI was performed in 311 (81%) of 385 individuals ≥60 years enrolled in the Atahualpa Project. Participants were classified in 2 groups according to whether they have severe edentulism (<10 remaining teeth) or not. Using multivariate logistic regression and exposure effect models, we assessed whether edentulism correlated with severity of white matter hyperintensities (WMHs), after adjusting for relevant confounders. Results: Mean age of participants was 70 ± 8 years (57% women). Severe edentulism was noticed in 152 (49%) individuals and moderate-to-severe WMHs in 81 (26%). In univariate analyses, moderate-to-severe WMHs were more common among edentulous individuals (OR 1.88, 95% CI 1.13-3.16, p = 0.015). Such difference became non-significant in the logistic regression model (OR 1.65, 95% CI 0.91-2.99, p = 0.098); in this model, the single relevant covariate was age. A weighted exposure effect model revealed no association of severe edentulism with moderate-to-severe WMH (average exposure effect: 0.73, 95% CI -0.01 to 0.16, p = 0.10). Conclusion: The relationship between edentulism and diffuse subcortical damage of vascular might be explained by the high prevalence of both variables in older adults.