The Potential Mediating Role of the Number of Remaining Teeth in the Association Between Age and Oropharyngeal Dysphagia Risk Among Community‐Dwelling Older Adults

BACKGROUND: Oropharyngeal dysphagia is a common issue among community-dwelling older adults and is associated with adverse health outcomes. This study examined whether the number of remaining teeth mediates the association between age and oropharyngeal dysphagia (OD) risk. METHODS: This cross-sectional study included 413 community-dwelling older adults (≥ 60 years) recruited from community health centers in Sulawesi, Indonesia. OD risk was assessed using a validated screening questionnaire. Oral examinations were conducted by trained nurses. Mediation analysis estimated the indirect, direct, and total effects of age on OD risk, adjusting for sex, educational level, hypertension, and diabetes mellitus. RESULTS: Participants' mean age was 69.9 years, with 15.3 remaining teeth. Mediation analysis revealed a significant indirect association between age and OD risk, mediated through the number of remaining teeth (adjusted β = 0.076, 95% CI: 0.034-0.114, p < 0.001). In contrast, the direct effect of age was not statistically significant. The total effect of age on OD risk remained significant. CONCLUSION: The number of remaining teeth statistically mediated the association between age and OD risk. Although causal inference is limited by the cross-sectional design, these findings highlight oral health as a potentially modifiable factor for reducing OD risk among older adults.