IADR Abstract Archives
Can Older Adults with Cognitive Impairment Use Dental-related Medication as Instructed?
Objectives: Mishandling medications is common in persons with dementia (PWDs), especially those with inadequate caregiver support. Although analgesics, antibiotics, and antimicrobic-rinses are routinely prescribed, uncertainty remains whether PWDs can handle dental-related-medication as instructed. We conducted a cross-sectional study to describe how persons with various cognitive function handle dental-related-medications and to examine the type and level of assistance they need to accomplish these tasks.
Methods: Fifty participants aged ≥50 years with documented cognitive impairment, were recruited. Participants first completed a cognitive assessment using the Standardized Mini-Mental Status Examination (SMMSE) and were classified into four groups based on their SMMSE scores (0-12, 13-20, 20-24, and ≥25). They were asked to set up an antibiotics pill-box and use a mouthwash as instructed. Verbal- and visual-prompts were given if participants made mistakes or could not complete the tasks. Scores were assigned for each task based on their performance and the number and type of prompts were documented. Their performance were compared using Wilcoxon-rank-sum and Kruskal-Wallis tests.
Results: Participants with SMMSE scores ≥25 could handle medications as instructed without assistance. Participants with a SMMSE score of 20-24 could set up antibiotics and use the mouthwash with some help. Although mistakes were common, most participants in this group could correct the mistakes and completed the tasks with verbal-prompts. Participants with SMMSE scores of 13-20 showed substantial impairment in medication management. They were unable to set up medication using the pill-box, but could use the mouthwash with frequent verbal and/or visual prompts. Participants with SMMSE scores of 0-12 lost their ability to handle medications and could not complete the tasks with frequent prompts.
Conclusions: Ability to handle dental-related-medications varied substantially in participants with cognitive impairment. Dentists should take this into their treatment planning considerations to prevent complications resulting from mishandling medications and achieve desired treatment outcomes.
Methods: Fifty participants aged ≥50 years with documented cognitive impairment, were recruited. Participants first completed a cognitive assessment using the Standardized Mini-Mental Status Examination (SMMSE) and were classified into four groups based on their SMMSE scores (0-12, 13-20, 20-24, and ≥25). They were asked to set up an antibiotics pill-box and use a mouthwash as instructed. Verbal- and visual-prompts were given if participants made mistakes or could not complete the tasks. Scores were assigned for each task based on their performance and the number and type of prompts were documented. Their performance were compared using Wilcoxon-rank-sum and Kruskal-Wallis tests.
Results: Participants with SMMSE scores ≥25 could handle medications as instructed without assistance. Participants with a SMMSE score of 20-24 could set up antibiotics and use the mouthwash with some help. Although mistakes were common, most participants in this group could correct the mistakes and completed the tasks with verbal-prompts. Participants with SMMSE scores of 13-20 showed substantial impairment in medication management. They were unable to set up medication using the pill-box, but could use the mouthwash with frequent verbal and/or visual prompts. Participants with SMMSE scores of 0-12 lost their ability to handle medications and could not complete the tasks with frequent prompts.
Conclusions: Ability to handle dental-related-medications varied substantially in participants with cognitive impairment. Dentists should take this into their treatment planning considerations to prevent complications resulting from mishandling medications and achieve desired treatment outcomes.
