Oral frailty tied to worse physical, mental health in older adults

Oral frailty can lead to negative outcomes in older adults, including poorer physical health and reduced cognition, according to a study. Early identification can help prevent these harmful consequences.

“Addressing oral frailty involves a multidisciplinary approach, combining dental care, nutrition, and overall health to improve the quality of life (QoL),” the investigators said.

Using a prespecified strategy, investigators searched several databases for published literature in English up to January 2024 using terms such as ‘oral’ and ‘frailty’.

Two independent reviewers assessed the identified references through titles and abstracts using the eligibility criteria for inclusion. Fifteen studies were included in the meta-analysis, with 12 cross-sectional and three prospective cohort studies.

Oral frailty definitions varied, and outcomes were categorized as follows: physical frailty, social frailty, cognition, mood, nutrition, QoL, and biochemical indices. [Proc Singap Healthc 2025;doi:10.1177/20101058251355290]

Older adults with oral frailty were more vulnerable to increased physical frailty, social frailty, late life depression, and deteriorating nutritional status. Notably, oral frailty was predictive of declining cognition and decreased health-related QoL.

Limited function

An earlier study by Tanaka defined oral frailty as functional limitations in three or more of the following domains: few remaining teeth, decreased masticatory performance, decreased articulatory oral motor skills, lower maximum tongue pressure, subjective difficulty chewing hard foods, and subjective difficulty swallowing. [Exp Gerontol 2023;172:112075]

“We propose that there should be a consensus on the identification of oral frailty via case finding approach,” the investigators said.

“Although there is yet to be a standardized approach in screening and identifying for oral frailty … questions that can be asked to the elderly during routine visits can include if they are suffering from tooth loss, if they have difficulty chewing or swallowing food, and if they have visited a dentist in the past 1 year,” they added. [J Oral Sci 2017;59:207-213; J Gerontol A Biol Sci Med Sci 2018;73:1661-1667]

Using these questions in addition to a bedside oral examination can help inform clinicians in determining whether oral frailty is a concern. This can prompt the referral to the relevant specialty, such as gerodontology, according to the investigators.

Preventive measures

A study has Ohara and colleagues suggested measures for oral frailty that aim to preserve oral health, including improvement of oral function on an individual basis and promotion of community health education. [J Gerontol A Biol Sci Med Sci 2018;73:1661-1667]

In addition, Kossioni and colleagues recommended oral health counselling for care of teeth and dentures, preventing hyposalivation and xerostomia, lifestyle changes, dietary advice, and regular dental checkups. [J Am Med Dir Assoc 2018;19:1039-1046]

“Multidisciplinary management of oral frailty and its associations are paramount to address the symptoms early,” the investigators said. [Community Dent Oral Epidemiol 2005;33:81-92]

“We propose that it involves not just oral health education and promotion but a comprehensive review of the geriatric patient with a focus on physical, social, and psychological factors,” they added.

“With more studies in this area, it is hoped that we can investigate and tailor interventions for our geriatric population, thereby reducing the adverse outcomes and allowing them to age well and live well,” the investigators said.