People with dementia, including Alzheimer’s disease, have significantly poorer oral health than other older adults, including more plaque, more cavities, severe gum disease, and fewer teeth, according to New York University (NYU). Even individuals with mild dementia are at higher risk of poor oral health, NYU says, and research suggests that inadequate oral hygiene practices are a major contributing factor.
Looking to improve these conditions, the NYU Rory Meyers College of Nursing has received a five-year, $3.47 million grant from the National Institute of Dental and Craniofacial Research and National Institute on Aging to improve the oral hygiene of people with mild dementia. The funding will be used to implement and study a unique oral health intervention involving family caregivers in New York and North Carolina.
Good oral hygiene, particularly routine tooth brushing and flossing, is critical in preventing the deterioration of oral health and general overall health for people with dementia. According to NYU, a few studies conducted in nursing homes have shown that with good oral hygiene, the oral health of people with dementia improves notably in a short period of time.
People with mild dementia often live at home and are cared for by family members who supervise and help with daily activities but often neglect oral hygiene. An intervention that incorporates both people with mild dementia and their caregivers to improve oral self-care could have long-term oral health benefits for people with dementia.
Using results from a pilot study, the researchers developed an intervention to help family caregivers guide people with mild dementia in carrying out oral hygiene. The intervention is designed to work with the caregiver and individual with mild dementia to identify challenges in oral care, help them learn to solve them, and improve the ability of the person with dementia to engage in effective oral care.
“To our knowledge, this is the first oral health intervention to be conducted among community-dwelling people with mild dementia, and the results of our pilot study suggest that a caregiver-assisted intervention can improve oral health outcomes,” said Bei Wu, PhD, the Dean’s Professor in Global Health at NYU Meyers, co-director of NYU Aging Incubator, and principal investigator.
“Introducing an intervention when dementia is still mild is ideal, because people with mild dementia still have the ability to perform oral hygiene tasks with minimal assistance,” said Brenda Plassman, PhD, professor of psychiatry and behavioral sciences at Duke Health and co-principal investigator.
Using the funding, the researchers will conduct a randomized control trial in New York City and North Carolina to test the intervention. In addition to measuring whether it improves oral hygiene, the researchers also will look at communication between dementia and their caregivers and will assess their oral health knowledge and confidence in their ability to improve their oral health.
“The team views the caregiver as a leader, guiding the individuals with mild dementia to maintain their independence in completing daily activities,” said Ruth Anderson, PhD, RN, associate dean for research at the University of North Carolina Chapel Hill School of Nursing and co-principal investigator.
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