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Journal of Gerontological Nursing, 2016;42(5):30–37
Published Online:https://doi.org/10.3928/00989134-20151218-03Cited by:20

Abstract

Poor oral health is a common problem among older adults in general and particularly among those with cognitive impairment. The current study was conducted to (a) explore direct and indirect relationships between cognitive function and oral health outcomes and (b) test the mediating effect of oral hygiene on the relationship between cognitive function and oral health. The current study used data from 327 community-dwelling older adults in West Virginia who completed an oral health evaluation, comprehensive cognitive assessment, and questionnaire about oral hygiene. Structure equation modeling was used to test for mediation. Results showed that more severe cognitive impairment was related to poorer oral health outcomes and less frequent tooth brushing and flossing. Tooth brushing serves as a mediator between cognitive impairment and oral health outcome. The current study suggests regular tooth brushing is a promising intervention to maintain oral health among individuals with cognitive impairment. [Journal of Gerontological Nursing, 42(5), 30–37.]

  • Al-Shammari K.F., Al-Ansari J.M., Al-Khabbaz A.K., Dashti A., Honkala E.J. (2007). Self-reported oral hygiene habits and oral health problems of Kuwaiti adults. Medical Principles and Practice, 16, 15–21.10.1159/000096134

    > Crossref MedlineGoogle Scholar
  • Amarasena N., Ekanayaka A.N.I., Herath L., Miyazaki H. (2002). Tobacco use and oral hygiene as risk indicators for periodontitis. Community Dentistry and Oral Epidemiology, 30, 115–123.10.1034/j.1600-0528.2002.300205.x

    > Crossref MedlineGoogle Scholar
  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

    > Google Scholar
  • Artero S., Touchon J., Ritchie K. (2001). Disability and mild cognitive impairment: A longitudinal population-based study. International Journal of Geriatric Psychiatry, 16, 1092–1097.10.1002/gps.477

    > Crossref MedlineGoogle Scholar
  • Axelsson P., Lindhe J. (1981). Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. Journal of Clinical Periodontology, 8, 239–248.10.1111/j.1600-051X.1981.tb02035.x

    > Crossref MedlineGoogle Scholar
  • Centers for Disease Control and Prevention. (2001). National health and nutrition examination survey examination protocol. Hyattsville, MD: U.S. Department of Health and Human Services.

    > Google Scholar
  • Chalmers J.M., Carter K.D., Spencer A.J. (2002). Caries incidence and increments in community-living older adults with and without dementia. Gerodontology, 19, 80–94.10.1111/j.1741-2358.2002.00080.x

    > Crossref MedlineGoogle Scholar
  • Chalmers J.M., Ettinger R.L. (2008). Public health issues in geriatric dentistry in the United States. Dental Clinics of North America, 52, 423–446.10.1016/j.cden.2007.12.004

    > Crossref MedlineGoogle Scholar
  • Christensen L.B., Petersen P.E., Krustrup U., Kjøller M. (2003). Self-reported oral hygiene practices among adults in Denmark. Community Dental Health, 20, 229–235.

    > MedlineGoogle Scholar
  • Davidson P.L., Rams T.E., Andersen R.M. (1997). Socio-behavioral determinants of oral hygiene practices among USA ethnic and age groups. Advances in Dental Research, 11, 245–253.10.1177/08959374970110020701

    > Crossref MedlineGoogle Scholar
  • Davies G.M., Worthington H.V., Ellwood R.P., Bentley E.M., Blinkhorn A.S., Taylor G.O., Davies R.M. (2002). A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5–6 year old children. Community Dental Health, 19, 131–136.

    > MedlineGoogle Scholar
  • Donabedian A. (1988). The quality of care: How can it be assessed?Journal of the American Medical Association, 260, 1743–1748.10.1001/jama.1988.03410120089033

    > CrossrefGoogle Scholar
  • Douglass J.M., Douglass A.B., Silk H.J. (2004). A practical guide to infant oral health. American Family Physician, 70, 2113–2120.

    > MedlineGoogle Scholar
  • Efron B., Tibshirani R. (1994). An introduction to the bootstrap. Boca Raton, FL: Chapman & Hall.

    > CrossrefGoogle Scholar
  • Eke P.I., Dye B.A., Wei L., Thornton-Evans G.O., Genco R.J. (2012). Prevalence of periodontitis in adults in the United States: 2009 and 2010. Journal of Dental Research, 91, 914–920.10.1177/0022034512457373

    > Crossref MedlineGoogle Scholar
  • Graham J.W., Hofer S.M., Donaldson S.I., MacKinnon D.P., Schafer J.L. (1997). Analysis with missing data in prevention research. In , Bryant K.J., Windle M., West S.G. (Eds.), The science of prevention: Methodological advances from alcohol and substance abuse research (pp. 325–366). Washington, DC: American Psychological Association.

    > Google Scholar
  • Grender J., Williams K., Walters P., Klukowska M., Reick H. (2013). Plaque removal efficacy of oscillating-rotating power toothbrushes: Review of six comparative clinical trials. American Journal of Dentistry, 26, 68–74.

    > MedlineGoogle Scholar
  • Hannele Syrjälä A.-M., Ylöstalo P., Sulkava R., Knuuttila M. (2007). Relationship between cognitive impairment and oral health: Results of the Health 2000 Health Examination Survey in Finland. Acta Odontologica Scandinavica, 65, 103–108.10.1080/00016350601083521

    > Crossref MedlineGoogle Scholar
  • Hu L.-T., Bentler P.M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.10.1080/10705519909540118

    > CrossrefGoogle Scholar
  • Humphrey L., Fu R., Buckley D., Freeman M., Helfand M. (2008). Periodontal disease and coronary heart disease incidence: A systematic review and meta-analysis. Journal of General Internal Medicine, 23, 2079–2086.10.1007/s11606-008-0787-6

    > Crossref MedlineGoogle Scholar
  • Jablonski R.A., Therrien B., Mahoney E.K., Kolanowski A., Gabello M., Brock A. (2011). An intervention to reduce care-resistant behavior in persons with dementia during oral hygiene: A pilot study. Special Care in Dentistry, 31, 77–87.10.1111/j.1754-4505.2011.00190.x

    > Crossref MedlineGoogle Scholar
  • Kline R.B. (2005). Principles and practice of structural equation modeling. New York, NY: Guilford Press.

    > Google Scholar
  • Lee K.H., Wu B., Plassman B.L. (2013). Cognitive function and oral health-related quality of life in older adults. Journal of the American Geriatrics Society, 61, 1602–1607.10.1111/jgs.12402

    > Crossref MedlineGoogle Scholar
  • Lee K.H., Wu B., Plassman B.L. (2014). Dental care utilization among older adults with cognitive impairment in the USA. Geriatrics & Gerontology International, 15, 255–260.10.1111/ggi.12264

    > Crossref MedlineGoogle Scholar
  • Liang J., Wu B., Plassman B., Bennett J.M., Beck J. (2014). Social stratification, oral hygiene, and trajectories of dental caries among old Americans. Journal of Aging and Health, 26, 900–923.10.1177/0898264314534891

    > Crossref MedlineGoogle Scholar
  • Little R.J.A. (1988). A test of missing completely at random for multivariate data with missing values. Journal of the American Statistical Association, 83, 1198–1202.10.1080/01621459.1988.10478722

    > CrossrefGoogle Scholar
  • MacKinnon D.P. (2008). Introduction to statistical mediation analysis. New York, NY: Taylor & Francis Group/Lawrence Erlbaum Associates.

    > Google Scholar
  • Peltola P., Vehkalahti M.M., Simoila R. (2007). Effects of 11-month interventions on oral cleanliness among the long-term hospitalised elderly. Gerodontology, 24, 14–21.10.1111/j.1741-2358.2007.00147.x

    > Crossref MedlineGoogle Scholar
  • Petersen P.E., Aleksejuniene J., Christensen L.B., Eriksen H.M., Kalo I. (2000). Oral health behavior and attitudes of adults in Lithuania. Acta Odontologica Scandinavica, 58, 243–248.10.1080/00016350050217073

    > Crossref MedlineGoogle Scholar
  • Petersen P.E., Bourgeois D., Ogawa H., Estupinan-Day S., Ndiaye C. (2005). The global burden of oral diseases and risks to oral health. Bulletin of the World Health Organization, 83, 661–669.

    > MedlineGoogle Scholar
  • Petersen P.E., Kandelman D., Arpin S., Ogawa H. (2010). Global oral health of older people—Call for public health action. Community Dental Health, 27, 257–267.10.1922/CDH_2711Petersen11

    > Crossref MedlineGoogle Scholar
  • Plassman B.L., Steffens D.C., Burke J.R., Welsh-Bohmer K.A., Newman T.N., Drosdick D., Breitner J.C.S. (2006). Duke Twins Study of Memory in Aging in the NAS-NRC Twin Registry. Twin Research and Human Genetics, 9, 950–957.10.1375/twin.9.6.950

    > Crossref MedlineGoogle Scholar
  • Quagliarello V., Ginter S., Han L., Van Ness P., Allore H., Tinetti M. (2005). Modifiable risk factors for nursing home-acquired pneumonia. Clinical Infectious Diseases, 40, 1–6.10.1086/426023

    > Crossref MedlineGoogle Scholar
  • Rubin D.B. (1987). Multiple imputation for nonresponse in surveys. New York, NY: John Wiley & Sons.10.1002/9780470316696

    > CrossrefGoogle Scholar
  • Runciman P., Watson H., McIntosh J., Tolson D. (2006). Community nurses' health promotion work with older people. Journal of Advanced Nursing, 55, 46–57.10.1111/j.1365-2648.2006.03882.x

    > Crossref MedlineGoogle Scholar
  • Scardina G.A., Messina P. (2008). Nutrition and oral health. Recenti Progressi in Medicina, 99, 106–111.

    > MedlineGoogle Scholar
  • Selwitz R.H., Ismail A.I., Pitts N.B. (2007). Dental caries. Lancet, 369, 51–59.10.1016/S0140-6736(07)60031-2

    > Crossref MedlineGoogle Scholar
  • Sinharay S., Stern H.S., Russell D. (2001). The use of multiple imputation for the analysis of missing data. Psychological Methods, 6, 317–329.10.1037/1082-989X.6.4.317

    > Crossref MedlineGoogle Scholar
  • Sobel M. (1982). Asymptotic confidence intervals for indirect effects in structural equation models. Sociological Methodology, 13, 290–312.10.2307/270723

    > CrossrefGoogle Scholar
  • Stewart R., Sabbah W., Tsakos G., D'Aiuto F., Watt R.G. (2008). Oral health and cognitive function in the Third National Health and Nutrition Examination Survey (NHANES III). Psychosomatic Medicine, 70, 936–941.10.1097/PSY.0b013e3181870aec

    > Crossref MedlineGoogle Scholar
  • Wiener R.C., Wu B., Crout R.J., Plassman B.L., McNeil D.W., Wiener M.A., Caplan D.J. (2012). Hygiene self–care of older adults in West Virginia: Effects of gender. American Dental Hygienists Association, 86, 231–238.

    > Google Scholar
  • Willumsen T., Fjaera B., Eide H. (2010). Oral health-related quality of life in patients receiving home-care nursing: Associations with aspects of dental status and xerostomia. Gerodontology, 27, 251–257.10.1111/j.1741-2358.2009.00344.x

    > Crossref MedlineGoogle Scholar
  • Wu B., Goedereis E.A., Crout R.J., Plassman B.L., DiNapoli E.A., McNeil D.W., Bai L. (2010). Recruitment of rural and cognitively impaired older adults for dental research. Special Care in Dentistry, 30, 193–199.10.1111/j.1754-4505.2010.00150.x

    > Crossref MedlineGoogle Scholar
  • Wu B., Plassman B.L., Crout R.J., Liang J. (2008). Cognitive function and oral health among community-dwelling older adults. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 63, 495–500.10.1093/gerona/63.5.495

    > Crossref MedlineGoogle Scholar
  • Zenthöfer A., Schröder J., Cabrera T., Rammelsberg P., Hassel A.J. (2014). Comparison of oral health among older people with and without dementia. Community Dental Health, 31, 27–31.10.1922/CDH_3309Zenthofer05

    > Crossref MedlineGoogle Scholar

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