Which factors influence the oral health of nursing-home residents with cognitive and motor impairments?
Tóm tắt
There is limited information available about the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments. The purpose of this study was to identify factors influencing the oral and denture hygiene and oral health of nursing-home residents with cognitive and motor impairments. The study was performed in nine nursing-homes in Germany. Sociodemographic and general data were collected for all participants (n = 150). The Clinical Dementia Rating (CDR) was used to identify the presence of dementia, and the Apraxia Screening Test (AST) was used to identify motor impairment. A comprehensive dental examination was also performed. This included the documentation of dental and denture status and the number of decayed, missing and filled teeth (DMFT). In addition, dental and denture hygiene were assessed using the Plaque Index (PI) and the Denture Hygiene Index (DHI). Univariate and multivariate regression models were used to analyse possible factors affecting the dependent target variables. In multivariate regression analysis, the factors that most strongly influenced greater PI were a lower number of medications taken (p = 0.018), poorer general health (p = 0.013) and the presence of dementia (p < 0.010). A more advanced age (p = 0.036) and longer nursing-home stay (p = 0.048) had a negative effect on the DHI. Furthermore, gender (p = 0.037, in favour of women), poorer general health (p = 0.003), presence of dementia (p = 0.003), and the absence of natural teeth (p = 0.028) influenced poorer oral health. The factors most strongly influenced greater number of missing teeth were a more advanced age (p = 0.021) and longer nursing-home stay (p = 0.015). In terms of fewer filled teeth, a shorter nursing-home stay (p = 0.002) was the factor most strongly influenced this. Poorer general health and the presence of apraxia and cognitive impairment are the main determinants for poorer oral hygiene and oral health among nursing-home residents. A longer nursing-home stay also seems to be relevant for oral health and denture hygiene.
Tài liệu tham khảo
Noble JM, Scarmeas N, Papapanou PN (2013) Poor oral health as a chronic, potentially modifiable dementia risk factor: review of the literature. Curr Neurol Neurosci Rep 13:384
Alzheimer's Disease International (2013) Policy Brief for G8 Heads of Government. The Global Impact of Dementia 2013–2050. Alzheimer's Disease International, London
Deutsche Alzheimer Gesellschaft (DAG) (2014) Mit Demenz im Pflegeheim. Praxisreihe der Deutschen Alzheimer Gesellschaft 14:1
Yoon MN, Ickert C, Slaughter SE et al (2018) Oral health status of long-term care residents in Canada: results of a national cross-sectional study. Gerodontology 35:359–364
Jordan AR, Micheelis W (2016) Fünfte Deutsche Mundgesundheitsstudie (DMS V). Institut der Deutschen Zahnärzte (IDZ Matierialreihe Band 35). Deutscher Ärzte-Verlag, Köln
Petersen PE, Ogawa H (2018) Promoting oral health and quality of life of older people—the need for public health action. Oral Health Prev Dent 16:113–124
Chalmers JM, Hodge C, Fuss JM et al (2002) The prevalence and experience of oral diseases in Adelaide nursing home residents. Aust Dent J 47:123–130
Janssens B, Vanobbergen J, Petrovic M et al (2018) The impact of a preventive and curative oral healthcare program on the prevalence and incidence of oral health problems in nursing home residents. PLoS ONE 13:e0198910
Pham TAV, Nguyen TQ (2018) Dental and periodontal problems of elderly people in Vietnamese nursing homes. Gerodontology. https://doi.org/10.1111/ger.12338
Thomson WM, Smith MB, Ferguson CA et al (2018) Oral status, cognitive function and dependency among New Zealand nursing home residents. Gerodontology. https://doi.org/10.1111/ger.12337
Ide K, Seto K, Usui T et al (2018) Correlation between dental conditions and comorbidities in an elderly Japanese population: a cross-sectional study. Medicine 97:e11075
Delwel S, Binnekade TT, Perez RS et al (2017) Oral health and orofacial pain in older people with dementia: a systematic review with focus on dental hard tissues. Clin Oral Investig 21:17–32
Ástvaldsdóttir Á, Boström AM, Davidson T et al (2018) Oral health and dental care of older persons—a systematic map of systematic reviews. Gerodontology 35:290–304
Okamoto N, Morikawa M, Okamoto K et al (2010) Tooth loss is associated with mild memory impairment in the elderly: the Fujiwara-kyo study. Brain Res 1349:68–75
Morris JC (1993) The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 43:2412–2414
Galvin JE, Meuser TM, Coats MA et al (2009) The "portable" CDR: translating the clinical dementia rating interview into a PDA format. Alzheimer Dis Assoc Disord 23:44–49
Vanbellingen T, Kersten B, Winckel A et al (2011) A new bedside test of gestures in stroke: the apraxia screen of TULIA (AST). J Neurol Neurosurg Psychiatry 82:389–392
Hassel AJ, Koke U, Schmitter M (2006) Factors associated with oral health-related quality of life in institutionalized elderly. Acta Odontol Scand 64:9–15
Silness J, Loe H (1964) Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 22:121–135
Wefers AP (1991) The “Denture Hygiene Index”. Dent Forum 1:3–15
World Health Organization (1987) Oral health surveys: basic methods. World Health Organization, Geneva
World Health Organization (1984) Oral health methods and indices. Caries prevalence: DMFT and DMFS. World Health Organization, Geneva
Johnell K, Fastbom J (2012) Comparison of prescription drug use between community-dwelling and institutionalized elderly in Sweden. Drugs Aging 29:751–758
Schwindling FS, Krisam J, Hassel AJ et al (2018) Long-term success of oral health intervention among care-dependent institutionalized seniors: findings from a controlled clinical trial. Community Dent Oral Epidemiol 46:109–117
Osterberg T, Mellström D, Sundh V (1990) Dental health and functional ageing. A study of 70-year-old people. Community Dent Oral Epidemiol 18:313–318
Ajwani S, Mattila KJ, Närhi TO et al (2003) Oral health status, C-reactive protein and mortality—a 10 year follow-up study. Gerodontology 20:32–40
Zenthöfer A, Navratil SD, Rammelsberg P et al (2015) Oral health and apraxia among institutionalized elderly people—a pilot study. Acta Odontol Scand 73:150–155
Klotz AL, Hassel AJ, Schröder J et al (2018) Is compromised oral health associated with a greater risk of mortality among nursing home residents? A controlled clinical study. Aging Clin Exp Res 30:581–588