Oral health and dentally-related functional profile in older adults with cognitive impairment

People with cognitive impairment often present with poor oral health, likely because of a declining ability to perform activities related to maintaining good oral health. To define levels of ability and develop supportive interventions, fifty-one participants (aged ≥ 50 years) with cognitive impairment were categorized into four groups based on their cognitive levels. They were asked to complete activities related to maintaining good oral health. These activities evaluated four aspects of what participants could or could not do: 1) accurately describe their mouth conditions, 2) understand and choose the dental treatment they want, 3) independently use medications, and 4) brush their teeth. Different prompts (e.g., pictures or repetition of the instruction) were given if the participants could not answer questions or complete tasks. Oral examination was conducted by a dentist. We found those with mild cognitive impairment were able to perform most activities. Participants with mild dementia needed help in making decisions about their dental treatment plan and in using medications. Participants with moderate dementia needed help in all aspects of most activities. Participants with severe dementia could not do most of the activities; however, some could brush their own teeth. Overall, worse oral hygiene was positively associated with the severity of cognitive impairment. In conclusion, ability to do tasks important for maintaining good oral health differed among groups of people with different cognitive levels. We posit that an individualized dental-care plan, based on a patient’s functional ability should be used by clinicians and caregivers of people with cognitive impairment.