and gowns once a week, sponge bath once a week, and
changing diapers as required. Cognitive impairment was
evaluated with Japanese versions of the Mini-Mental State
Examination (MMSE).
7
Trained neuropsychologists measured
MMSE every 6 months. ADLs were evaluated using
the modified Barthel Index.
8
Both MMSE and ADL have a
30-point scale for healthy older people, with a score of 0
indicating complete loss of cognition and dependence. We
took axillary temperatures two times a day; a febrile day
was defined as the axillary temperature rising above 37.8
C
at either of the two daily measurements. Patients who had
febrile days for more than 7 cumulative days during 2 years
were assumed to be patients with fever. The Tohoku University
Ethics Committee granted ethical approval, and informed
consent was obtained from the patients or their
families.
All comparisons were made between the oral care and
non–oral care groups or between dentate and edentate patients
using two-way analysis of variance. Statistical significance
was accepted as
P
.05. All data are expressed as
mean
SD.