Oral Health Suffers Among Alzheimer's Patients' Caregivers

One of the several ways in which Alzheimer’s affects our society is its effect on those who serve as caregivers. In addition to the many nurses and other health care professionals who are involved, many family members, friends and neighbors provide informal or unpaid care.  In 2015, caregivers of people with Alzheimer’s and other dementias provided an estimated 18.1 billion hours of informal assistance, a contribution to the nation valued at $221.3 billion.

In addition to the extensive amount of time spent by the caregivers, the tasks involved are wide-ranging and in some instances all encompassing, often including assistance with all of the person’s activities of daily living and instrumental activities of daily living.

As the sixth leading cause of death in the U.S., Alzheimer’s is one of the most debilitating and costly diseases of our time. Just behind heart disease and cancer, it’s the third most common cause of death for older people.      

Some 5.4 million Americans have Alzheimer’s disease, most of whom are age 65 and older, with about 200,000 who have younger-onset Alzheimer’s.

For some caregivers, the demands of their activities may cause declines in their own health.  A 2003 study revealed that caregivers of people with dementia were more likely than non-caregivers to report that their own health was fair or poor. Caregivers of people with dementia were also more likely than caregivers of other older people to say that caregiving made their own health worse. Also, 74 percent of caregivers of people with Alzheimer’s disease and other dementias reported that they were “somewhat concerned” to “very concerned” about maintaining their own health since becoming a caregiver.

Although evidence exists for negative effects of caregiving on general health, evidence regarding possible effects on caregivers’ oral health is lacking.  Because of this lack of evidence, investigators at the Eastman Institute for Oral Health and the Alzheimer’s Association of the Finger Lakes developed a pilot survey to learn caregivers’ responses to 10 questions about the effect of their caregiving on their own oral health.  The survey, supervised by Dr. Ralph Saunders, a University of Rochester professor who holds appointments in Dentistry and in Geriatrics/Aging Division in the Department of Medicine, was filled out by 126 people who attend support group meetings organized by the Alzheimer’s Association.

Questions addressed possible negative effects on caregivers’ brushing their own teeth, cleaning between teeth, cleaning dentures, expenses for caregivers’ own oral care, and difficulty scheduling dental appointments for themselves or others for whom they had responsibility.

Results suggest that the entire population surveyed felt that there were negative effects on some level. More than 44 percent felt that the quality of their own oral health has decreased because of their caregiving responsibilities for someone with Alzheimer’s disease.

“Because this initial survey suggests that serving as an Alzheimer’s disease caregiver may adversely affect their oral health,” Dr. Saunders said, “we are contemplating additional studies to explore the results in greater depth, as well as different ways we can education caregivers about the risks of neglecting their oral health.”