Exploring associations between oral health and frailty in community-dwelling older people

Abstract

Background: In frail older people with natural teeth factors like polypharmacy, reduced salivary flow, a decrease of oral self-care, general healthcare issues, and a decrease in dental care utilization contribute to an increased risk for oral complications. On the other hand, oral morbidity may have a negative impact on frailty. Objective: This study explored associations between oral health and two frailty measures in community-dwelling older people. Design: A cross-sectional study. Setting: The study was carried out in a Primary Healthcare Center (PHC) in The Netherlands. Participants: Of the 5,816 persons registered in the PHC, 1,814 persons were eligible for participation at the start of the study. Measurements: Two frailty measures were used: 1. Being at risk for frailty, using Electronical Medical Record (EMR) data, and: 2. Survey-based frailty using ‘The Groningen Frailty Indicator’ (GFI). For oral health measures, dental-record data (dental care utilization, dental status, and oral health information) and self-reported oral problems were recorded. Univariate regression analyses were applied to determine the association between oral health and frailty, followed by age- and sex-adjusted multivariate logistic regressions. Results: In total 1,202 community-dwelling older people were included in the study, 45% were male and the mean age was 73 years (SD=8). Of all participants, 53% was at risk for frailty (638/1,202), and 19% was frail based on the GFI (222/1,202). A dental emergency visit (Odds Ratio (OR)= 2.0, 95% Confidence Interval (CI)=1.33;3.02 and OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07;3.99), and making dietary adaptations (OR=2.66, 95% CI=1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01) were associated with being at risk for frailty and survey-based frailty respectively. Conclusions: A dental emergency visit and self-reported oral health problems are associated with frailty irrespective of the approach to its measurement. Healthcare professionals should be aware of the associations of oral health and frailty in daily practice.

Association between dry mouth and physical frailty among community‐dwelling older adults in Japan: The Otassha Study

“…Based on these findings, poor oral health status is associated with physical frailty 10 . Previous studies have reported that oral health‐related factors associated with physical frailty include deterioration of oral function, such as reduced chewing ability and swallowing function, and periodontal disease 11‐15 . Moreover, xerostomia, which presents as a subjective feeling of oral dryness, has been reported to be associated with a greater likelihood of frailty 16,17 …”

“…10 Previous studies have reported that oral healthrelated factors associated with physical frailty include deterioration of oral function, such as reduced chewing ability and swallowing function, and periodontal disease. [11][12][13][14][15] Moreover, xerostomia, which presents as a subjective feeling of oral dryness, has been reported to be associated with a greater likelihood of frailty. 16,17 Dry mouth is a common source of discomfort among older people and has negative physical and psychological effects.…”

Association of Health Literacy and Socioeconomic Status with Oral Health Among Older Adults in Ghana: A Moderation Analysis of Social Capital

“…Oral health describes the “state of being free from mouth and facial pain, tooth infection and decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing”(WHO, 2021). Poor oral health, such as dental caries and periodontal disease, negatively affects the cognitive and physical functioning of affected people (Everaars et al, 2021; WHO, 2021). Crucially, oral health problems are common among older persons because of a lifetime of exposure to socioenvironmental health determinants (Petersen & Ogawa, 2018; WHO, 2021).…”

Evaluation of an Oral Care Program to Improve the Oral Health of Home-Dwelling Older People

“…Oral health is important, as multiple associations between oral health and general health exist. Inflammation in the oral cavity may disturb HbA1C levels in diabetes patients; oral inflammation may contribute to the manifestation of rheumatoid arthritis, and malnutrition and aspiration pneumonia are associated with poor oral health [ 5 , 6 , 7 , 8 , 9 , 10 ]. Oral health and inattention to oral hygiene by older people are associated with frailty and even mortality [ 2 , 10 , 11 , 12 , 13 ].…”