{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T02:46:20Z","timestamp":1764989180658,"version":"3.46.0"},"reference-count":34,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2023,6,13]],"date-time":"2023-06-13T00:00:00Z","timestamp":1686614400000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,4,14]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Distinct subtypes of Alzheimer\u2019s disease (AD) and related dementias (RD) might have different effects on dental care usage and economic burden. To determine the effects of AD and RD on specific types of dental care usage (preventive and treatment visits) and dental care costs from different payers (total and out-of-pocket costs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted using the Medicare Current Beneficiary Survey in 2016. This study identified 4268 community dwelling older adults with and without Alzheimer\u2019s disease and related dementias (ADRD) from a nationally representative sample of Medicare beneficiaries. Dental care usage and costs are based on self-reported data. Preventive dental events included preventive and diagnosis events. Treatment dental events included restorative, oral surgery and other events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>This study identified 4268 (weighted N=30 423 885) older adults, including 94.48% without ADRD, 1.90% with AD and 3.63% with RD. Compared with older adults without ADRD, those with AD had similar dental care usage, but those with RD were 38% less likely to have treatment visit (OR: 0.62; 95%\u2009CI: 0.41 to 0.94) and had a 40% reduced number of total treatment visits (incidence rate ratio: 0.60; 95%\u2009CI: 0.37 to 0.98). RD was not associated with dental care costs, but AD was associated with higher total costs (\u03b2: 1.08; 95%\u2009CI: 0.14 to 2.01) and higher out-of-pocket costs (\u03b2: 1.25; 95%\u2009CI: 0.17 to 2.32).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with ADRD were more likely to have adverse dental care outcomes. Specifically, RD was associated with lower treatment dental care usage and AD was associated with higher total and out-of-pocket dental care costs. Effective patient-centred strategies should be used to improve dental care outcomes in patients with distinct subtypes of ADRD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2022-068944","type":"journal-article","created":{"date-parts":[[2023,6,14]],"date-time":"2023-06-14T13:40:20Z","timestamp":1686750020000},"page":"e068944","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of Alzheimer\u2019s disease and related dementias on dental care usage and economic burden in older adults: a cross-sectional study"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1909-6260","authenticated-orcid":false,"given":"Minghui","family":"Li","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy and Translational Science, The University of Tennessee Health Science Center, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isaac K","family":"Donkor","sequence":"additional","affiliation":[{"name":"Department of Medicine Health and Society, Vanderbilt University, Nashville, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongjie","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Translational Science, The University of Tennessee Health Science Center, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Scarborough Health Network Centenary Hospital, Scarborough, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7247-0077","authenticated-orcid":false,"given":"Xiangxiang","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Pediatric and Community Dentistry, College of Dentistry, University of Tennessee, Memphis, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z Kevin","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy and Outcomes Sciences, University of South Carolina, Columbia, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,14]]},"reference":[{"key":"2025120518125068000_13.6.e068944.1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1111\/j.1754-4505.2000.tb01152.x","article-title":"Behavior management and communication strategies for dental professionals when caring for patients with dementia","volume":"20","author":"Chalmers","year":"2000","journal-title":"Spec Care Dentist"},{"key":"2025120518125068000_13.6.e068944.2","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.2147\/CIA.S164957","article-title":"Patient characteristics associated with screening positive for Alzheimer\u2019s disease and related dementia","volume":"13","author":"Fowler","year":"2018","journal-title":"Clin Interv Aging"},{"key":"2025120518125068000_13.6.e068944.3","unstructured":"NIH . 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