Cognitive impairment, oral self-care function and dental caries severity in community-dwelling older adults.

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. Materials and 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). Conclusion Oral care capacity mediates the association between cognition and dental caries severity in community-dwelling older adults.