Oral Health Disparities Among Elders With and Without Cognitive Impairment

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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.