Effects of oral self-care on oral, cognitive, and daily performance functions in rural community-dwelling older people with mild cognitive impairment

Abstract

Background. To determine the effect of an oral self-care programme on oral, cognitive, and daily performance functions in rural communitydwelling older people with mild cognitive impairment. Methods. Community-dwelling older people in 10 villages were assigned based on the village they lived and at the request of the local government to either the intervention group or control group. The oral self-care programme was conducted by a dentist and two dental hygienists twice a month for a total of eight sessions. Oral functions included functions of the lips and cheeks, mastication function, swallowing function, oral diadochokinesis, the longest phonation of ‘ah’, and cleanliness of the mouth. Cognitive function was assessed using Mini Mental State Examination. The effect of the programme on cognitive function was evaluated using the Digit Symbol Substitution Test (DSST), part A of the Trail-Making Test, and Five Cognitive Tests. Daily performance was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC). Results. 32 women in the intervention group and 32 women in the control group were analysed. Intervention had a significant effect on swallowing function in terms of Repetitive Saliva Swallowing Test score (p<0.001) and the longest phonation of ‘ah’ (p=0.014), cognitive function in terms of the processing speed measured by DSST score (p=0.004), and daily performance in terms of TMIG-IC score (p=0.027) and the instrumental independence sub-score (p=0.015). Surprisingly, mastication power improved significantly in the control group (p=0.036). Conclusion. The oral self-care programme may be an effective means to delay oral, physical, and cognitive decline in rural, communitydwelling older people with mild cognitive impairment.