Effects of Integrative Cognitive Function Improvement Program on Cognitive Function, Oral Health, and Mental Health in Older People: A Randomized Clinical Trial

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Keywords

cerebral blood flow; cognition; electroencephalogram; mental health; older adults; oral health.

Abstract

We aimed to investigate the effects of an integrative cognitive function improvement program that combined existing cognitive, emotional, and physical therapies on cognitive function, oral health, and mental health in elder participants. Participants were classified into one of the following groups: cognitively normal (CN; n = 18), mild cognitive impairment (MCI; n = 17), and control (n = 17). An integrative cognitive function improvement program was administered to the CN and MCI groups for six weeks. To measure cognitive function, electroencephalogram (EEG) and cerebral blood flow (CBF) were evaluated, and to measure oral health, the O’Leary index, Löe & Silness index, tongue coating, unstimulated saliva flow rate, and oral muscle strength were measured. To measure mental health status, mental health, happiness and social support were measured. The CN and MCI groups showed a significant change in EEG-based indices for awareness level and physical stress. Regarding oral health, the O’Leary and the Löe & Silness index score decreased significantly in the CN and MCI groups. Saliva flow rate increased significantly in the CN and MCI groups. In regards to mental health, the happiness score increased post-intervention in the CN and MCI groups. In conclusion, the integrative cognitive function improvement program was effective in improving cognitive function, oral health, and mental health of elder people.

Citation

Jung, E. S., Choi, Y. Y., & Lee, K. H. (2022). Effects of Integrative Cognitive Function Improvement Program on Cognitive Function, Oral Health, and Mental Health in Older People: A Randomized Clinical Trial. International journal of environmental research and public health, 19(21), 14339. https://doi.org/10.3390/ijerph192114339

DOI

10.3390/ijerph192114339

EWB Constructs:

(2) life satisfaction; (3) positive affect

EWB Measures:

(3) Happiness: a subjective happiness scale [DOI:10.22143/HSS21.12.3.48] in Korean:

data availability:

Yes

data availability details:

The data that support the findings of this study are available from the corresponding author upon reasonable request.

brain imaging paradigm:

N/A

EEG results:
(1) The post hoc test revealed that the Arousal Level significantly improved after the intervention in the Cognitively Normal group and MCI group compared to pre-intervention.
(2) Post-intervention Physical Tension values were significantly improved than those measured after the first session in the Cognitively Normal group and those measured at pre-intervention in the MCI group.
(3) no significant MD differences in the post hoc test

emotion results: Satisfaction with life improved in this study, as study participants experienced increases in interpersonal interactions and psychological support through cognitive, emotional, and physical activities over six weeks and these factors contributed to enhanced happiness in old age.

brain region/circuit:

Exclusion Criteria:

excluding those who withdrew themselves from the study and those who were lost to follow-up

Inclusion Criteria

(1) understanding of study purposes and voluntary consent for participation,
(2) no problem in communicating with others,
(3) being ambulatory
(4) undergoing no pharmacological therapy to improve cognitive function, and
(5) no history of participating in other cognitive intervention programs.

Non-EWB Behavioral
Measures:

Barthel Index was used to measure performance in activities of daily living
Geriatric Oral Health Assessment Index (GOHAI)
(4) the Medical Outcomes Study Social Support Survey (MOSSSS): Social support
(1)Oral health-related quality of life was assessed by using the Oral Health Impact Profile (OHIP-14)
(2) Korean General Health Questionnaire (KGHQ) - Goldberg’s General Health Questionnaire

First author:

Eun-Seo Jung

species:

Human

sample size:

study design:

(5) RCT

longitudinal data?

Yes

younger controls?

interventions:

Integrative Cognitive Function Improvement Program:
1. Cognitive Activities: Oral Health Education and the Use of a Workbook
2. Emotional Activities: Music Therapy and Laughter Therapy
3. Physical Activities: Whole-Body Exercise and Mouth Exercise

study population:

(1) cognitively healthy adults
(2) patients with (pre)clinical dementia

sex (% female):

88.46%

ethnicity (%white)

Age (mean, sd):

≥65 (only provide age range)

biological/Physiological Measures:

(3) vascular; (4) others, indicate
dental exam: Iowa Oral Performance Instrument (IOPI), O’Leary index (dental plaque), Löe & Silness index (gingivitis), tongue coating, unstimulated saliva flow rate, and oral muscle strength