Denture wearing and cognitive function among Indian edentulous middle-aged and older adults: the mediating role of masticatory function

Oral health, including dentition and denture use, has been recognised as a potentially modifiable factor associated with cognitive function in older adults, yet the association between denture wearing and cognitive function and the relevant underlying mechanisms remain understudied in the Indian population. This cross-sectional study aimed to test whether masticatory function statistically mediates the association between denture wearing and cognitive function in edentulous middle-aged and older Indian adults. Data were obtained from the 2017–18 Wave 1 of the Longitudinal Ageing Study in India (LASI). We included 3,892 Indian edentulous adults aged 45 and older; edentulism and denture status were self-reported, with participants missing key data excluded during screening. A weighted mediation analysis, consisting of three sequential models, was conducted to examine whether masticatory function mediates the association between denture wearing and cognitive function. Bootstrap method and Sobel test were applied to examine this mediating association. Of the 3,892 edentulous participants included in the analysis, 732 (18.81%) reported wearing dentures. After full adjustment, edentulous denture wearers had significantly better masticatory function (unstandardized regression coefficient B = 0.371, p < 0.001) and cognitive function (B = 0.229, p < 0.001) than edentulous non-denture wearers. Moreover, masticatory function was positively associated with cognitive function (B = 0.038, p = 0.003). Bootstrap method further showed significant total (B = 0.229, 95% CI [0.152, 0.308]), direct (B = 0.214, 95% CI [0.137, 0.296]) associations between denture wearing and cognitive function, as well as a significant indirect association through masticatory function (B = 0.014, 95% CI [0.005, 0.026]). Denture wearing is associated with better cognitive function among edentulous Indian adults aged 45 years and older, and this association is partially mediated by masticatory function. Sociodemographic gaps in denture use suggest targeted support for vulnerable older adults; integrated multi-sector public health policies coordinating oral and cognitive health should be prioritized.