# Functionally-tailored Oral Care Intervention for Community-dwelling Older Adults with Dementia and Their Caregivers

> **NIH NIH R21** · UNIVERSITY OF IOWA · 2020 · $230,415

## Abstract

7. PROJECT SUMMARY
Persons with dementia (PWD) gradually lose their ability to perform oral self-care, leading to poor oral hygiene. Poor oral
hygiene increases the risks of dental caries, periodontal disease and other oral pathologies, and initiates a cascade of oral
health decline among PWD, which in turn may accelerate cognitive decline. Importantly, these changes often begin
before nursing home (NH) placement. Besides pain and discomfort, poor oral health can lead to agitation and delirium and
increase caregiver (CG) stress. It can also affect quality of life, cause malnutrition, increase insulin resistance, and lead to
aspiration pneumonia, cardiovascular complications, and other life-threatening conditions in these vulnerable individuals.
Early intervention is essential to stop/slow down the oral health decline and its cognitive/systemic impacts in PWD.
Existing oral hygiene interventions have demonstrated efficacy in improving oral health, reducing aspiration pneumonia
and even slowing down cognitive decline. However, these programs were designed for NH residents and are not tailored
for the great majority of PWD, who reside in the community. As such, they fail to account for the reciprocal physical and
emotional relationship between the PWD and their family caregivers and its influence on oral care. Furthermore, although
oral hygiene education is a standard component of dementia dental care, it is usually not tailored to each patient's level of
oral self-care function. In response to these gaps, we propose a study to develop and evaluate a functionally-tailored oral
hygiene intervention to improve oral health for community-dwelling PWD while reducing caregiver burdens and
improving care partner relationships. The study consists of two phases corresponding to two aims. For Aim 1 we will
develop a modularized, functionally-tailorable oral care intervention based on literature review and CG interview input.
We anticipate eight training modules that can be used alone or in varying combinations to provide functionally-
appropriate oral care rehabilitation for PWD and need-based skills training their family CGs. These will be adapted from
Mouth Care Without a Battle, a validated oral hygiene intervention developed for NH residents with dementia. Aim 2 will
examine the efficacy and feasibility of the proposed intervention using a randomized controlled design among 40
PWD/CG pairs. After baseline assessment, a 4-week, dyadic, hand-on, functionally-tailored oral care intervention will be
delivered to 20 PWD/CG dyads. Control group participants (n=20) will receive the standard oral hygiene education
currently provided to PWD during dental care. Data collection will occur at baseline, 4-weeks and 3 months. Differences
between the control and intervention groups with regard to PWD outcomes (e.g., oral hygiene and behavior symptoms
during oral care), caregiver outcomes (e.g., burden, self-efficacy) and the care partner relationship will be explored.
T...

## Key facts

- **NIH application ID:** 10001002
- **Project number:** 5R21NR017347-02
- **Recipient organization:** UNIVERSITY OF IOWA
- **Principal Investigator:** Xi Chen
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $230,415
- **Award type:** 5
- **Project period:** 2019-08-22 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10001002

## Citation

> US National Institutes of Health, RePORTER application 10001002, Functionally-tailored Oral Care Intervention for Community-dwelling Older Adults with Dementia and Their Caregivers (5R21NR017347-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10001002. Licensed CC0.

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