dementia C D A J O U R N A L , V O L 4 9 , Nº 9
C.E. Credit
Oral Health and Dementia Paul Glassman, DDS, MA, MBA
abstract There is a significant increase in the number of people over age 60 who are living with dementia. It is important that oral health practitioners understand conditions that lead to cognitive decline in older individuals as well as strategies for providing oral health care services for these individuals. These strategies include conducting office-based care as well as creating community-engaged oral health systems that can help people with Alzheimer’s disease and dementia obtain and maintain good oral health. Keywords: Oral health, dental treatment, Alzheimer’s disease, dementia, cognitive decline, communityengaged oral health systems
AUTHOR Paul Glassman, DDS, MA, MBA, is a professor and associate dean for research and community engagement at California Northstate University College of Dental Medicine in Elk Grove, Calif. Conflict of Interest Disclosure: None reported.
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mproved living conditions, increasing lifespans and better health care have resulted in shifting disease patterns across the world.1 One result has been a 113% increase between 1990 and 2010 in the worldwide number of people over age 60 living with dementia.2 This is a far larger increase than the increase in those living with cardiovascular disease (22%), diabetes (80%) and vision and hearing impairment (49% and 42%). In 2020, the World Health Organization (WHO) reported that there were 50 million people living with dementia and over 10 million new cases each year.3 The WHO also reported that the total number of people with dementia is projected to reach 82 million in 2030 and 152 million in 2050. These trends have major implications for health and the provision of health care, including oral health care. A recent systematic review indicated the relationship between learning and memory, complex attention and executive function with poor oral
health in old age.4 Mechanisms for this association include reduced ability to perform daily mouth care procedures, difficulty accessing and receiving dental care and reduced salivary flow.5–9 Given the increasing number of people with some form of dementia, it is important that oral health practitioners understand conditions that lead to cognitive impairment in older individuals as well as strategies for providing oral health care services for these individuals.10,11
Dementia and Other Causes of Cognition Impairment
There are a number of conditions that can lead to cognitive impairment in older adults. These conditions are often categorized as the “3 Ds” — delirium, depression and dementia.12 They can all produce presenting signs that include memory loss, lack of responsiveness, confusion and difficulty completing tasks of daily life. SEP TEMBER 2 0 2 1
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