Association between dentures and the rate of falls in dementia

A New Prototype of Smart Wearable Monitoring System Solution for Alzheimer's Patients

Purpose

The daily life management of patients with Alzheimer’s disease (AD) constitutes a significant and rapidly expanding health-care responsibility. In this study, an innovative prototype of a wireless-sensing smart wearable medical device (SWMD) is proposed as a multi-functions solution for Alzheimer patients. The SWMD is aimed to assemble three main biomedical engineering advances: 1) use of a Wi-Fi microcontroller, 2) simultaneous monitoring of a set of vital biomarkers, and 3) cautions of fall down conditions, in addition to GPS location indicator.

Methods

The SWMD employs a Wi-Fi controller that is incorporated with electronic circuits to monitor three vital signals (temperature, heart rate, and oxygen saturation), fall down conditions in three directions (X, Y, and Z axis), and GPS location. The SWMD was connected to the Firebase Service (database hosted on the Internet Cloud). The proposed device was tested on 13 normal volunteers. The left side, right side, forward, and backward fall down conditions were assessed. The prototype’s functions during daily activity such as rising hand, sitting down or standing up, and walking conditions were also assessed.

Results

The three assembled functions were all successfully incorporated to build the SWDM device as a suggested solution offering real-time alerts during daily activity to AD patients. The Bland-Altman statistical test showed no significant difference (p-value >0.05) between the SWMD biomarkers’ acquisition and the reference methods. The gyro/accelerator sensor yielded 93% sensitivity in fall down detection and 95% specificity during daily activities. The GPS yielded correct positioning of the SWDM holder, while the internet cloud allowed saving and managing all vital biomarkers daily.

Conclusion

The SWMD is a possible solution for daily life support for AD patients. It incorporates three functions in one single device, GPS location indicator, monitoring set of biomarkers, and fall down alert, which are all controlled via a Wi-Fi micro controller on-line connected to Internet Cloud. It successfully would allow the management of the daily records as well as the real-time alerts to remote persons.

Oral Health Status and Need for Oral Care in an Aging Population: A Systematic Review

Background. The world population is aging. This phenomenon is accompanied by an increase in the number of elderly with dementia, whose oral hygiene care is a challenge. Objective. This paper presents a literature review of oral health status and the need for oral care in people with dementia, as compared to people without dementia and also of the relationship between periodontal disease and cognitive impairment. Methods. A systematic review was conducted in PubMed, CINAHL, and the Cochrane Library. Fifty-six articles met the inclusion criteria and were consequently included for quality assessment and data extraction. Results. No significant differences were found between both groups with regard to the number of present teeth, DMFT Index, edentulousness/use of denture, and orofacial pain. Coronal/root caries and retained roots were more common in people with dementia than in those without dementia. Most of the participants with dementia presented gingival bleeding or inflammation and they suffered from the periodontal disease more than people without dementia. Conclusions. Poor oral health is a common condition among the elderly with dementia. The education process of caregivers might improve the oral health status of people with dementia. Finally, periodontal disease might contribute to the onset or progression of dementia.

Oral health and orofacial pain in older people with dementia: a systematic review with focus on dental hard tissues

Objective

The aim of this review was to provide a systematic overview including a quality assessment of studies about oral health and orofacial pain in older people with dementia, compared to older people without dementia.

Methods

A systematic literature search was performed in PubMed, CINAHL, and the Cochrane Library. The following search terms were used: dementia and oral health or stomatognathic disease. The quality assessment of the included articles was performed using the Newcastle-Ottawa Scale (NOS).

Results

The search yielded 527 articles, of which 37 were included for the quality assessment and quantitative overview. The median NOS score of the included studies was 5, and the mean was 4.9 (SD 2.2). The heterogeneity between the studies was considered too large to perform a meta-analysis. An equivalent prevalence of orofacial pain, number of teeth present, decayed missing filled teeth index, edentulousness percentage, and denture use was found for both groups. However, the presence of caries and retained roots was higher in older people with dementia than in those without.

Conclusions

Older people with dementia have worse oral health, with more retained roots and coronal and root caries, when compared to older people without dementia. Little research focused on orofacial pain in older people with dementia.

Clinical relevance

The current state of oral health in older people with dementia could be improved with oral care education of caretakers and regular professional dental care.

[Oral health in dementia: Results of a telephone helpline]

BACKGROUND

The complexity of dental care and oral hygiene for people with dementia increases with increasing numbers of residual teeth.

AIM

This study was carried out to determine whether the offer of a telephone helpline on oral health and dementia would be utilized.

MATERIAL AND METHODS

Over a period of 1 year contacts received by a telephone helpline manned by three oral healthcare staff were collected and analyzed.

RESULTS

From 01 June 2012 to 31 May 2013 a total of 355 callers (180 healthcare staff and 175 relatives) presented and discussed 2535 problems. The average duration of a call was 21 min. Almost one quarter of the callers were looking for mobile dental care services and 14.4 % were looking for a dentist specialized in caring for patients with dementia. Oral disease, oral care and conflicts between stakeholders on aspects of oral health were discussed. Of the healthcare staff three quarters asked about training to improve the oral health of people with dementia.

CONCLUSION

The demand on the specialists of the helpline showed a substantial knowledge deficit of healthcare staff and relatives. The study confirmed a wide range of oral health issues of people with dementia. Knowledge on oral and denture hygiene and on oral disease could be introduced into primary training and continued professional education. In addition to the lack of knowledge, deficits also exist in the oral healthcare system for people with dementia. Politicians and healthcare stakeholders are encouraged to incorporate oral healthcare for people with dementia into strategies and dementia networks.