The Impact of Online Interactive Platform Services on Oral Health Behaviors in Older Adults with Mild Cognitive Impairment: Protocol for a Randomized Controlled Trial [Response to Letter]

Dear editor

We are writing in response to the letter submitted by Dr. Swarup Ghosh regarding our article, “The Impact of Online Interactive Platform Services on Oral Health Behaviors in Older Adults With Mild Cognitive Impairment: Protocol for a Randomized Controlled Trial” by Yin et al¹ published in the Journal of Multidisciplinary Healthcare. We sincerely thank Dr. Swarup Ghosh et al for their interest in our work and for their thoughtful comments on our paper.

We greatly appreciate your recognition of our research and the insightful suggestions provided. In response to the comments and suggestions you have provided, I will address each point as follows:

First, regarding the accuracy of the research hypothesis, we sincerely appreciate your valuable feedback. Although we have clearly outlined our objectives in the introduction, we acknowledge that some readers may still find it difficult to directly grasp the research hypothesis. Therefore, we will ensure that the research hypothesis is more explicitly stated in future revisions.

Second, regarding the inclusion of secondary outcomes in the title, due to word count limitations and our primary focus on promoting oral health behaviors, we did not explicitly present the secondary outcomes in the title. However, we have thoroughly presented these outcomes in both the abstract and the main body of the article.

Third, we think that presenting baseline data in the research protocol is not essential. We plan to include baseline data in the results section after the study has been completed. At the time of drafting the research protocol, the study was still in the recruitment phase, and data analysis had not yet been conducted, which is why baseline data were not provided. Furthermore, we have clarified that the diagnosis of mild cognitive impairment (MCI) is made by a specialized neurologist, and the Mini Mental State Evaluation (MMSE) scale is used to assess cognitive ability. We also recognize the sensitivity of the Montreal Cognitive Assessment (MoCA) scale for MCI screening,² and will use the MoCA scale in future MCI screenings.

Fourth, we fully acknowledge that visual impairments may affect the completion of online assessments. To address this issue, we have implemented two strategies in our current protocol to enhance feasibility: (1) our platform is designed according to age-friendly principles, with font sizes and color schemes that are suitable for older adults;³ and (2) caregivers are permitted to assist with the assessments. We will also ensure that the inclusion and exclusion criteria are more clearly defined in future studies to minimize potential confounding factors.

Fifth, regarding the sample size calculation, we have reviewed it and identified a minor error. We appreciate your correction and will take extra care to ensure accuracy in our future research and practice.