Association between Dementia Severity and Oral Hygiene Management Issues in Older Adults with Alzheimer's Disease: A Cross-Sectional Study

Maki Shirobe; Ayako Edahiro; Keiko Motokawa; Shiho Morishita; Yuki Ohara; Yoshiko Motohashi; Masanori Iwasaki; Yutaka Watanabe; Hirohiko Hirano

doi:10.3390/ijerph20053841

Association between Dementia Severity and Oral Hygiene Management Issues in Older Adults with Alzheimer's Disease: A Cross-Sectional Study

Int J Environ Res Public Health. 2023 Feb 21;20(5):3841. doi: 10.3390/ijerph20053841.

Authors

Maki Shirobe¹, Ayako Edahiro¹, Keiko Motokawa¹, Shiho Morishita^{1

2}, Yuki Ohara¹, Yoshiko Motohashi¹, Masanori Iwasaki¹, Yutaka Watanabe^{1

3}, Hirohiko Hirano^{1

4}

Affiliations

¹ Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.
² School of Health Sciences, Meikai University, 1 Meikai, Urayasu-shi, Chiba 279-8550, Japan.
³ Gerodontology, Department of Oral Health Science, Hokkaido University, Kita 13-jo Nishi 7-chome, Kita-ku, Sapporo-shi, Hokkaido 060-8586, Japan.
⁴ Dentistry and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan.

Abstract

Oral hygiene management issues vary across types and clinical stages of dementia. We aimed to clarify the issues related to oral hygiene management in older adults with Alzheimer's disease (AD) according to stages defined by the Functional Assessment Staging of Alzheimer's Disease (FAST). In all, 397 records (45 men and 352 women; average age, 86.8 years; age range, 65-106) from older adults with AD were used for the cross-sectional study. We used data from a cohort of older adults (≥65 years old) who required long-term care and lived in the Omorimachi area of Yokote City, Akita Prefecture, Japan. Multilevel logistic regression analysis was conducted to examine the associations of the FAST stage, set as the exposure variable, with oral hygiene management parameters set as outcome variables. Compared to the reference category (combined FAST stage 1-3), FAST stages 6 and 7 had significantly higher odds ratios for refusal of oral health care, dependence in performing oral health care, and rinsing and gargling disability. FAST stages 4 and 7 were associated with dental plaque accumulation. Oral health care for older adults with AD should be planned appropriately according to dementia severity.

Keywords: functional assessment staging of Alzheimer’s disease; oral function; oral health care; oral hygiene; refusal to care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Alzheimer Disease* / complications
Cross-Sectional Studies
Female
Humans
Long-Term Care
Male
Oral Health
Oral Hygiene

Grants and funding

This research was funded by the Japan Agency for Medical Research and Development (grant numbers: 16dk0110018h0001, 17dk0110018h0002, and 18dk0110018h0003), JSPS KAKENHI (grant numbers: 16K11907, 19K19342, 20H03903, and 22K17296), and MHLW GA Program (grant number: 20GA1003).