Oral Health Disparities Among Elders With and Without Cognitive Impairment

描述(由申请者提供)：该项目旨在评估老年人中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，整个老年人口中口腔疾病和疾病的发病率增加，认知受损的老年人，主要是痴呆症患者，口腔健康问题的频率明显增加。这一证据表明，与正常老年人相比，患有痴呆症的认知受损老年人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。这一研究领域进一步受到限制，因为它依赖于认知功能的粗略筛查措施，没有利用可用于更具体地确定认知损害的广泛可用的神经心理学工具，也没有包括来自照顾者/告密者的投入。这个R21应用程序建议通过从西弗吉尼亚州当地记忆和健康诊所招募250名70岁以上的齿状社区老年人来检查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)使用综合方法进行认知功能评估；(C)面对面/电话访谈，包括研究参与者及其照顾者/信息者，以获得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；以及(D)从医疗记录中提取数据。这个项目将为以后的纵向队列研究奠定基础，使用横断面调查与认知损害有关的口腔健康恶化机制。根据我们的初步研究，我们假设患有痴呆症的老年人的口腔健康状况明显比患有CIND或没有认知障碍的人差；此外，CIND患者的口腔健康状况将比没有认知障碍的人更差。由于口腔健康问题和认知障碍在70岁及以上的老年人中都很常见，这项研究的成功完成将为制定预防策略提供强有力的科学基础，以解决老年人的口腔健康问题。

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.