{
  "abstract": "Edentulism may contribute to functional disability in older adults, yet cross-national evidence combining multiple analytic strategies and mechanistic assessment remains limited. This study examined the association between edentulism and disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) across England, the United States, and India. We analyzed harmonized data from the English Longitudinal Study of Ageing (ELSA; n = 9,102), the Health and Retirement Study (HRS; n = 22,156), and the Longitudinal Ageing Study in India (LASI; n = 31,816) for adults aged 60 years or older. Cross-sectional associations were estimated using inverse probability weighting (IPW) and augmented IPW. Longitudinal Cox proportional hazards models were applied in ELSA and HRS. Mediation through grip strength, body mass index (BMI), and depressive symptoms was assessed with counterfactual causal mediation analysis on the risk-difference scale. Edentulism was associated with higher odds of ADL (pooled odds ratio 1.30, 95% confidence interval 1.20–1.42) and IADL disability (1.27, 1.11–1.45). Longitudinal analyses confirmed elevated hazard ratios for incident ADL (1.19, 1.09–1.30) and IADL disability (1.30, 1.19–1.43). Grip strength accounted for the largest proportion mediated (approximately 50% in ELSA and HRS, and 5–14% in LASI); BMI and depressive symptoms showed little mediation. In LASI, denture use among edentulous participants was associated with lower disability odds. Edentulism was consistently associated with functional disability across three countries, with grip strength partially accounting for this association, although the cross-sectional design precludes establishing temporality. Oral rehabilitation may partly buffer this risk and merits further prospective investigation.",
  "abstract_shown": true,
  "affiliations": [
    "State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China."
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Wanqi Tang",
      "orcid": "0009-0007-0272-8862"
    },
    {
      "affs": [
        0
      ],
      "name": "Libang He"
    },
    {
      "affs": [
        0
      ],
      "name": "Min Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiyao Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6rd2tdrnfb785.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0361422",
  "fulltext_url": "https://europepmc.org/articles/PMC13722177",
  "id": "6rd2tdrnfb785",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0361422",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Activities of Daily Living"
    ],
    [
      "heading",
      "Adults"
    ],
    [
      "heading",
      "Age Groups"
    ],
    [
      "heading",
      "Aging"
    ],
    [
      "heading",
      "Anatomy"
    ],
    [
      "heading",
      "Biology and Life Sciences"
    ],
    [
      "heading",
      "Biomechanics"
    ],
    [
      "heading",
      "Body Weight"
    ],
    [
      "heading",
      "Developmental Biology"
    ],
    [
      "heading",
      "Digestive System"
    ],
    [
      "heading",
      "Education"
    ],
    [
      "heading",
      "Elderly"
    ],
    [
      "heading",
      "Hand Strength"
    ],
    [
      "heading",
      "Head"
    ],
    [
      "heading",
      "Health Care"
    ],
    [
      "heading",
      "Jaw"
    ],
    [
      "heading",
      "Mathematical and Statistical Techniques"
    ],
    [
      "heading",
      "Mathematics"
    ],
    [
      "heading",
      "Medicine and Health Sciences"
    ],
    [
      "heading",
      "Metaanalysis"
    ],
    [
      "heading",
      "Organism Development"
    ],
    [
      "heading",
      "People and Places"
    ],
    [
      "heading",
      "Physical Sciences"
    ],
    [
      "heading",
      "Physiological Parameters"
    ],
    [
      "heading",
      "Physiological Processes"
    ],
    [
      "heading",
      "Physiology"
    ],
    [
      "heading",
      "Population Groupings"
    ],
    [
      "heading",
      "Quality of Life"
    ],
    [
      "heading",
      "Research Article"
    ],
    [
      "heading",
      "Research and Analysis Methods"
    ],
    [
      "heading",
      "Schools"
    ],
    [
      "heading",
      "Social Sciences"
    ],
    [
      "heading",
      "Sociology"
    ],
    [
      "heading",
      "Statistical Methods"
    ],
    [
      "heading",
      "Statistics"
    ],
    [
      "heading",
      "Teeth"
    ],
    [
      "heading",
      "Weight Loss"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Digestive system/Teeth"
    ],
    [
      "plos",
      "/Biology and life sciences/Anatomy/Head/Jaw/Teeth"
    ],
    [
      "plos",
      "/Biology and life sciences/Biomechanics/Hand strength"
    ],
    [
      "plos",
      "/Biology and life sciences/Developmental biology/Organism development/Aging"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Physiological parameters/Body weight/Weight loss"
    ],
    [
      "plos",
      "/Biology and life sciences/Physiology/Physiological processes/Aging"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Digestive system/Teeth"
    ],
    [
      "plos",
      "/Medicine and health sciences/Anatomy/Head/Jaw/Teeth"
    ],
    [
      "plos",
      "/Medicine and health sciences/Health care/Quality of life/Activities of daily living"
    ],
    [
      "plos",
      "/People and places/Population groupings/Age groups/Adults/Elderly"
    ],
    [
      "plos",
      "/Physical sciences/Mathematics/Statistics/Statistical methods/Metaanalysis"
    ],
    [
      "plos",
      "/Research and analysis methods/Mathematical and statistical techniques/Statistical methods/Metaanalysis"
    ],
    [
      "plos",
      "/Social sciences/Sociology/Education/Schools"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://europepmc.org/articles/PMC13722177?pdf=render",
  "pmcid": "PMC13722177",
  "pmid": "42961862",
  "published": "2026-10-30",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/6rd2tdrnfb785.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:20:55Z",
      "native_id": "10.1371/journal.pone.0361422",
      "source": "plos",
      "url": "https://doi.org/10.1371/journal.pone.0361422"
    },
    {
      "first_seen": "2026-11-02T03:21:21Z",
      "native_id": "MED:42961862",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42961862"
    },
    {
      "first_seen": "2026-11-03T12:22:44Z",
      "native_id": "PMC13722177",
      "source": "pmc",
      "url": "https://doi.org/10.1371/journal.pone.0361422"
    }
  ],
  "subjects": [
    {
      "field": "biology",
      "origin": "heading:Developmental Biology",
      "subfield": "developmental-biology"
    },
    {
      "field": "mathematics",
      "origin": "heading:Statistical Methods",
      "subfield": "statistics"
    },
    {
      "field": "medicine",
      "origin": "plos:anatomy",
      "subfield": "physiology"
    }
  ],
  "title": "Edentulism and functional disability in older adults: A longitudinal and cross-national study in England, the United States, and India",
  "title_text": "Edentulism and functional disability in older adults: A longitudinal and cross-national study in England, the United States, and India",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:44Z",
  "url": "https://research.draconitic.com/paper/6rd2tdrnfb785",
  "venue": "PLOS One",
  "versions": []
}