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

Abstract Aims: 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. Methods and results: 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 question- naire. 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. Conclusion: 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.