Constructional apraxia screening and oral health among hospitalized older adults: A cross-sectional study

Apraxia may hinder oral self-care and is associated with poor oral hygiene. Intersecting Pentagons Test (IPT) is a simple screening tool for constructional apraxia (CA) that tests the ability to copy a bidimensional figure. In this study we investigated whether IPT is useful to identify subjects that need interventions to support oral health in a cohort of geriatric inpatients.

We assessed oral health through the decayed, missing or filled teeth index, plaque index, and periodontal screening and recording tool. We inquired about autonomy in oral hygiene activities through a standardized questionnaire. Among subjects with CA (273 out of 478 hospitalized subjects aged > 65 years) we found a higher prevalence of edentulism (P = 0.04), periodontal disease (PD) (P = 0.03), and dependence in oral hygiene activities (P < 0.001). Only 34.8% of nonautonomous apraxic patients had a caregiver that supplied oral care. In an age and sex-adjusted generalized linear model, IPT proved to be an independent predictor of dependence in oral care, reaching 61.5% sensitivity in identifying dependent patients.

Among elderly inpatients, there is a significant association between IPT results, poor oral health status, and dependence in oral hygiene activities. Positivity to IPT should prompt proper device counseling and caregiver education.