Oral Health Disparities Among Elders With and Without Cognitive Impairment

描述（由申请人提供）：本项目旨在评估老年人认知障碍与口腔健康下降的关系。有强有力的临床证据表明，总体而言，老年人口中口腔疾病和病症的发病率有所增加，而认知受损的老年人（主要是痴呆症患者）出现口腔健康问题的频率明显更高。这一证据表明，相对于未受损的老年人，认知受损老年痴呆患者的口腔健康问题程度存在明显差异。然而，这些结论在多大程度上适用于那些认知受损但没有痴呆（CIND）的老年人还没有确定。这一领域的研究进一步受到限制，因为它依赖于认知功能的总体筛查措施，没有利用广泛的可用神经心理学工具来更具体地确定认知障碍，也没有包括照顾者/线人的输入。本R21应用程序旨在通过招募250名来自西弗吉尼亚州当地记忆和健康诊所的70岁以上有牙齿的社区老年人来研究认知功能和口腔健康之间的关系。数据收集将包括四个部分：(a)口腔健康检查；(b)采用综合方法评价认知功能；(c)面对面/电话访谈，包括研究参与者及其护理者/提供信息者，以获取有关口腔健康和口腔卫生的信息，以及可能影响口腔健康和认知状况的社会人口、行为、功能、一般健康状况和情感因素；(d)从病历中提取数据。该项目将为后续的纵向队列研究奠定基础，该研究采用横断面调查方法研究与认知障碍相关的口腔健康恶化机制。根据我们的初步研究，我们假设老年痴呆患者的口腔健康状况明显比CIND患者或无认知障碍的老年人差；此外，与没有认知障碍的人相比，患有CIND的人口腔健康状况更差。由于口腔健康问题和认知功能障碍在70岁及以上的老年人中普遍存在，本研究的成功完成将为制定早期干预老年人口腔健康问题的预防策略提供强有力的科学依据。

DESCRIPTION (provided by applicant): This project aims to assess the relationship of cognitive impairment with declining oral health among older adults. There is strong clinical evidence to suggest an increased incidence of oral diseases and conditions in the elderly population overall and a significantly greater frequency of oral health problems in cognitively impaired older adults, primarily those with dementia. This evidence suggests that there exist clear differences in the extent of oral health problems in cognitively impaired elders with dementia relative to unimpaired elders. However, the extent to which these conclusions would extend to those elderly individuals who are cognitively impaired but not demented (CIND) has not been determined. This area of research is further limited in that it has relied upon gross screening measures of cognitive function, has not utilized the broad range of available neuropsychological instruments that would allow more specific determination of cognitive impairment, and has not included input from caregivers/informants. This R21 application proposes to examine the relationship between cognitive function and oral health by recruiting 250 dentate community dwelling older adults, aged 70+, from local memory and health clinics in West Virginia. Data collection will include four components: (a) oral health examination; (b) cognitive function evaluation using a comprehensive approach; (c) face-to-face/telephone interviews, including both study participants and their caregiver/informant, to obtain information about oral health and oral hygiene, and sociodemographic, behavioral, functional, general health status, and affective factors that could potentially affect oral health and cognitive status; and (d) data extraction from medical records. This project will set the stage for a later longitudinal cohort study using a cross-sectional investigation into mechanisms of oral health deterioration as related to cognitive impairment. Based on our preliminary studies, we hypothesize that oral health status among older adults with dementia is significantly worse than in those with CIND or without cognitive impairment; and further, individuals with CIND will have poorer oral health status than those without cognitive impairment. Since both oral health problems and cognitive impairment are common among older adults aged 70 and above, successful completion of this study will provide a strong scientific foundation for the development of prevention strategies for early intervention to address oral health problems among older adults.