Caring for people with Alzheimer’s disease
With an ageing population, you can expect to see more patients with Alzheimer’s disease. Tailoring their dental care to their needs is crucial.
‘Dementia’ describes diseases that cause problems with memory, thinking, language and perception. Alzheimer’s disease is the most common of these. Symptoms usually begin with mild memory loss or issues with solving problems or making decisions. Difficulties with memory, communication and orientation become more pronounced as the disease progresses.
Approximately 520,000 people have dementia caused by Alzheimer’s disease in the UK. However, prevalence is expected to rise with the ageing population. Around 40,000 of these people are currently under 65-years-old.[i]
What causes Alzheimer’s disease?
In short, we don’t know what causes Alzheimer’s disease. Many scientists agree on the involvement of two proteins – amyloid and tau – which build up in the brain. Consequently, they disrupt communication between neutrons and cell function. Research is on-going as to why this happens.[ii]
Gender is another risk factor for all types of dementia. Almost twice as many women over 65 develop Alzheimer’s disease compared to men. Although the reasons for this are unclear, living longer and loss of the hormone oestrogen after menopause are possible causes. A variable risk factor is lifestyle – physically, mentally and socially active people have a lower chance of developing dementia. In addition, the prevention of diabetes, heart problems, high blood pressure, high cholesterol and obesity can further lower risk.[iii]
Oral health and Alzheimer’s disease
Studies show that patients with dementia have significantly worse periodontal health than those without.[iv] Furthermore, there is evidence to suggest a link between the bacteria involved with gingival disease and Alzheimer’s disease.[v] However, a causal relationship has not been established and more research is needed.
In the meantime, patients with Alzheimer’s disease need an effective oral hygiene routine, which is tailored to their needs and abilities. As a result, they need products to suit their level of dexterity and simple routines they can follow at home. For those with more developed disease, the dental team may need to work with the care home team.
Caring for the unsung heroes
Caring for patients with Alzheimer’s disease is important, but so is supporting their carers. There are an estimated 70,000 informal carers for people with dementia in the UK. Providing this care puts a massive strain on an individual’s physical and mental health, as they are likely to neglect their own wellbeing. Only 52.8% of those surveyed said they looked after themselves ‘well enough’.[vi] As such, they will require all the support they can get. This might just mean offering appointments at different times. Or it could involve recommending quick and effective oral hygiene guidance more suited to their routines.
September is World Alzheimer’s Month. Review your protocols to ensure you deliver the best possible care to all those affected.
[i] Alzheimer’s Society. About dementia. Types of dementia. Alzheimer’s disease. [Accessed August 2019]
[iii] Alzheimer’s Society. About dementia. Types of dementia. Who gets Alzheimer’s disease? [Accessed August 2019]
[iv] Maldonado A, Laugisch O, Burgin W, Sculean A, Eich S. Clinical periodontal variables in patients with and without dementia – a systematic review and meta-analysis. Clin Oral Investig. 2018 Sep;22(7):2463-2474. doi: 10.1007/s00784-018-2523-x. Epub 2018 Jun 22.
[v] Dominy SS et al. Porphyromonas gingivalis in Alzheimer’s disease brains: Evidence for disease causation and treatment with small-molecule inhibitors. Science Advances. Jan 2019’ 5(1), eaau3333. DOI: 10.1126/sciadv.aau3333