title: Cognitive impairment, oral self-care function and dental caries severity in community-dwelling older adults.
abstract: OBJECTIVE
  To investigate whether oral self-care function mediates the associations between cognitive impairment and caries severity in community-dwelling older adults.
  
  
  BACKGROUND
  Cognitive impairment affects activities of daily living and compromises oral health, systemic health and quality of life in older adults. However, the associations among cognitive impairment, oral self-care capacity and caries severity remain unclear. This increases difficulty in developing effective interventions for cognitively impaired patients.
  
  
  METHODS
  Medical, dental, cognitive and functional assessments were abstracted from the dental records of 600 community-dwelling elderly. 230 participants were selected using propensity score matching and categorised into normal, cognitive impairment but no dementia (CIND) and dementia groups based on their cognitive status and a diagnosis of dementia. Multivariable regressions were developed to examine the mediating effect of oral self-care function on the association between cognitive status and number of caries or retained roots.
  
  
  RESULTS
  Cognitive impairment, oral self-care function and dental caries severity were intercorrelated. Multivariable analysis showed that without adjusting for oral self-care capacity, cognition was significantly associated with the number of caries or retained roots (p = 0.003). However, the association was not significant when oral self-care capacity was adjusted (p = 0.125). In contrast, individuals with impaired oral self-care capacity had a greater risk of having a caries or retained root (RR = 1.67, 95% CI 1.15, 2.44).
  
  
  CONCLUSIONS
  Oral care capacity mediates the association between cognition and dental caries severity in community-dwelling older adults.
authors.affiliation: Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Clark
authors.forename: Hong
authors.initials: H
authors.lastname: Chen
authors.forename: Supawadee
authors.initials: S
authors.lastname: Naorungroj
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D060825:Cognitive Dysfunction / Q000150:complications*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000150:complications*; D003731:Dental Caries / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009735:Nursing Homes; D009909:Oral Health; D009910:Oral Hygiene; D011788:Quality of Life; D012648:Self Care
keywords: cognitive impairment; community dwelling; dental caries; older adults; oral self-care function