Dental management of Alzheimer patients. A predictive test of dental cooperation in individualized treatment planning.
The aim of the study was to investigate a possible relationship in Alzheimer patients between the stage of dementia, cognitive and functional capacity, and behavior as a dental patient. A special index for assessing behavior in the dental setting was used. The 40 participants were inmates of a nursing home and fulfilled the criteria for Alzheimer's disease in accordance with DSM-III-R. A deficiency in the dental behavior index (DBI) of 50% or less did not correlate with cognitive, functional, or graphic capacity. These subjects were generally aware of earlier regular dental treatment and behaved as if dental visits were familiar to them, although their cognitive, functional, and graphic capacities were more impaired than disclosed by the dental behavior index. A deficiency in the dental behavior index of 50% or more was more correlated with the other capacity assessments. Finding a proper treatment level for an Alzheimer patient is a delicate task in which it is essential to balance awareness of various aspects of impairment and realistic anticipation of benefit. The dental behavior index can be an appropriate instrument in this complex process.
Nordenram
G
G
Department of Oral Diagnostic Sciences, Karolinska Institute, and Gerontology Research Center, Stockholm, Sweden.
Ryd-Kjellén
E
E
Ericsson
K
K
Winblad
B
B
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology*; D001364:Awareness / Q000502:physiology; D001519:Behavior / Q000502:physiology; D003071:Cognition / Q000502:physiology; D003299:Cooperative Behavior; D016321:Dental Care for Aged; D017742:Dental Care for Chronically Ill; D005260:Female; D005544:Forecasting; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008568:Memory / Q000502:physiology; D009059:Mouth Diseases / Q000628:therapy; D009483:Neuropsychological Tests; D009735:Nursing Homes; D010347:Patient Care Planning; D011597:Psychomotor Performance / Q000502:physiology; D014076:Tooth Diseases / Q000628:therapy