Author ORCID Identifier
0000-0001-5190-530X
Date of Graduation
5-2022
Document Type
Thesis (MS)
Program Affiliation
Neuroscience
Degree Name
Masters of Science (MS)
Advisor/Committee Chair
Cameron B. Jeter, PhD
Committee Member
Rodrigo Morales, PhD
Committee Member
June M. Sadowsky, DDS, MPH
Committee Member
Paul E. Schulz, MD
Committee Member
Gena D. Tribble, PhD
Committee Member
Kartik Venkatachalam, PhD
Abstract
Poor oral health is a predictor of cognitive decline in elderly populations and has been shown to precede dementia. As cognitive decline progresses, patients are likely to move from the community into nursing facilities. We hypothesize that severity of dementia and residency type will impact the oral health of patients with dementia. Fifty-two participants of two dementia levels were recruited from the UTHealth Neurocognitive Disorders Center and two Houston-area nursing homes. A standardized oral health assessment, plaque index, and oral bacteria analysis determined participants’ oral health status. Further, data was collected on participants’ medical history, oral hygiene habits, dietary habits, and swallowing ability. Across dementia level, we found no visible differences in oral health, but we did find microscopic differences in oral bacterial composition between patients with mild and severe dementia. Of the 127 species that significantly differed, bacteria causing periodontitis, tooth decay, and pneumonia were found in greater abundance in patients with severe dementia. Further, patients with severe dementia had significantly worse swallowing ability, which can result in fatal aspiration pneumonia. Across residency type we found that compared to community dwelling patients with dementia, nursing home residents with dementia have significantly worse oral health according to the number of teeth chewing pairs, plaque index, and oral bacteria composition. Of the 138 species that significantly differed across residency type, we found nursing home subjects had greater abundance of oral disease-causing bacteria. Overall, we recommend that oral health assessments of patients with dementia not only include a visual oral iv health screening, but also include an analysis of oral bacteria composition as pathogenic oral species have grave potential to worsen oral and systemic disease.
Keywords
Neurocognitive disorders, oral microbiome, dementia, elderly, oral health, clinical