Zahnmedizinische Versorgung älterer Menschen: Chancen und Herausforderungen

Nitschke, Ina; Hahnel, Sebastian

doi:10.1007/s00103-021-03358-1

Cited by 11 publications

(13 citation statements)

References 22 publications

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“…Despite interrelated biochemical processes in intraoral inflammation and AD [ 349 , 355 ], there are few clinical studies investigating the effectiveness of oral treatment approaches in AD. Difficulties in recruitment include ethical issues, the health status of people with disabilities, lack of compliance, required involvement of relatives, treatment limitations, and economic issues [ 351 , 396 , 414 ]. However, oral treatment approaches are very promising to be integrated into a multidomain approach.…”

Section: Discussionmentioning

confidence: 99%

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Ablinger¹,

Dressel

Rott³

et al. 2022

Biomedicines

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Alzheimer’s disease is one of the most common neurodegenerative diseases in the western population. The incidence of this disease increases with age. Rising life expectancy and the resulting increase in the ratio of elderly in the population are likely to exacerbate socioeconomic problems. Alzheimer’s disease is a multifactorial disease. In addition to amyloidogenic processing leading to plaques, and tau pathology, but also other molecular causes such as oxidative stress or inflammation play a crucial role. We summarize the molecular mechanisms leading to Alzheimer’s disease and which potential interventions are known to interfere with these mechanisms, focusing on nutritional approaches and physical activity but also the beneficial effects of cognition-oriented treatments with a focus on language and communication. Interestingly, recent findings also suggest a causal link between oral conditions, such as periodontitis or edentulism, and Alzheimer’s disease, raising the question of whether dental intervention in Alzheimer’s patients can be beneficial as well. Unfortunately, all previous single-domain interventions have been shown to have limited benefit to patients. However, the latest studies indicate that combining these efforts into multidomain approaches may have increased preventive or therapeutic potential. Therefore, as another emphasis in this review, we provide an overview of current literature dealing with studies combining the above-mentioned approaches and discuss potential advantages compared to monotherapies. Considering current literature and intervention options, we also propose a multidomain interdisciplinary approach for the treatment of Alzheimer’s disease patients that synergistically links the individual approaches. In conclusion, this review highlights the need to combine different approaches in an interdisciplinary manner, to address the future challenges of Alzheimer’s disease.

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Section: Discussionmentioning

confidence: 99%

Interdisciplinary Approaches to Deal with Alzheimer’s Disease—From Bench to Bedside: What Feasible Options Do Already Exist Today?

Ablinger¹,

Dressel

Rott³

et al. 2022

Biomedicines

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“…The allocation of the MMSE groups was based on the MMSE score categories described by Perneczky et al [ 38 ]. Since the OrBiD study primarily tested the effects of interventions [ 33 , 36 ] that can be integrated into everyday clinical practice, the authors opted for a slightly modified classification of dementia severity based on participants’ ability to receive therapy [ 39 ] and, associated with this, their ability to participate in assessments and measurement procedures within the study. The basis for setting the thresholds was an expert panel that indicated a range in the MMSE of 16–20 as the threshold for impairment of daily activities [ 35 ].…”

Section: Methodsmentioning

confidence: 99%

Use of handgrip strength measurement as an alternative for assessing chewing function in people with dementia

2022

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Background Chewing ability and handgrip strength can be independent explanatory factors of physical fitness. The usability of measurement procedures for assessing chewing function in people with dementia seems to be limited. This study aimed to show an association between handgrip strength and chewing function to enable the use of handgrip strength measurement as an alternative for determining chewing parameters in people with dementia. Methods The data analysed here are part of the OrBiD (Oral Health, Bite Force and Dementia) pilot study. A total of 120 participants were assigned to five evaluation groups based on their cognitive abilities using the Mini-Mental State Examination (MMSE). The MMSE groups in this data analysis were “no dementia” (noDem, MMSE 28–30), “mild cognitive impairment” (mCI, MMSE 25–27), and “mild dementia” (mDem, MMSE 18–24). Handgrip strength, maximum occlusal force, and chewing efficiency were measured. Results The Mini-Mental State Examination scores among all participants (n = 71) resulted in a median of 27 and a range of 18–30. An association between maximum handgrip strength and the cognitive impairment of the participants was shown. Nevertheless, the use of handgrip strength measurement as an alternative for determining chewing function was not verified in this study. Conclusions The feasibility and reliability of chewing function measurements in people with dementia should be investigated. Existing measurement procedures may need to be adapted or new assessments may need to be developed to be usable in people with dementia. Trial registration ClinicalTrials.gov NCT03775772.

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“…Die zahnmedizinische Betreuung von Senioren ist eine Herausforderung auf der einen Seite, aber auch eine Chance für einen zufriedenstellenden Alltag, da viele Senioren sich sehr freuen und dankbar sind, wenn sich das Team dem Problem des älteren Patienten in Ruhe annimmt 4 .…”

Section: Aufsuchende Zahnmedizinische Versorgungskonzepteunclassified

“…Bei den meisten Menschen treten die oben genannten Phasen im Alterungsprozess hintereinander auf. Ziel jeder (zahn-)ärztlichen Begleitung der Menschen muss sein, den Übertritt in die nächste Phase weitest möglich nach hinten zu verschieben oder – bestenfalls – ganz zu verhindern 4 .…”

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“…Hier gelten dann ausschließlich die Regeln der stationären Versorgung, die bisher keine ausreichenden zahnärztlichen Positionen vorsieht. Dies stellt ein großes Problem für die Zahnmedizin dar, da Patienten für diesen Zeitraum für eine zahnärztliche Behandlung oder Vorsorge kaum zugänglich sind.Die zahnmedizinische Betreuung von Senioren ist eineHerausforderung auf der einen Seite, aber auch eine Chance für einen zufriedenstellenden Alltag, da viele Senioren sich sehr freuen und dankbar sind, wenn sich das Team dem Problem des älteren Patienten in Ruhe annimmt[4].▶ Tab. 11 Versorgungskonzepte zur zahnmedizinischen Betreuung außerhalb der zahnärztlichen Praxis (Grundbesteck = Spiegel, Sonden, Pinzette, Serviette, Watterollen, Handschuhe, Desinfektionstücher, Schreibunterlagen etc.)…”

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