Influence of Poor Oral Health on Physical Frailty: A Population‐Based Cohort Study of Older British Men

Abstract

ObjectivesTo investigate the associations between objective and subjective measures of oral health and incident physical frailty.DesignCross‐sectional and longitudinal study with 3 years of follow‐up using data from the British Regional Heart Study.SettingGeneral practices in 24 British towns.ParticipantsCommunity‐dwelling men aged 71 to 92 (N = 1,622).MeasurementsObjective assessments of oral health included tooth count and periodontal disease. Self‐reported oral health measures included overall self‐rated oral health; dry mouth symptoms; sensitivity to hot, cold, and sweet; and perceived difficulty eating. Frailty was defined using the Fried phenotype as having 3 or more of weight loss, grip strength, exhaustion, slow walking speed, and low physical activity. Incident frailty was assessed after 3 years of follow‐up in 2014.ResultsThree hundred three (19%) men were frail at baseline (aged 71–92). Having fewer than 21 teeth, complete tooth loss, fair to poor self‐rated oral health, difficulty eating, dry mouth, and more oral health problems were associated with greater likelihood of being frail. Of 1,284 men followed for 3 years, 107 (10%) became frail. The risk of incident frailty was higher in participants who were edentulous (odds ratio (OR) = 1.90, 95% confidence interval (CI) = 1.03–3.52); had 3 or more dry mouth symptoms (OR = 2.03, 95% CI = 1.18–3.48); and had 1 (OR = 2.34, 95% CI = 1.18–4.64), 2 (OR = 2.30, 95% CI = 1.09–4.84), or 3 or more (OR = 2.72, 95% CI = 1.11–6.64) oral health problems after adjustment for age, smoking, social class, history of cardiovascular disease or diabetes mellitus, and medications related to dry mouth.ConclusionThe presence of oral health problems was associated with greater risks of being frail and developing frailty in older age. The identification and management of poor oral health in older people could be important in preventing frailty.

Frailty and oral health: Findings from the Concord Health and Ageing in Men Project

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Association between oral health and frailty: A systematic review of longitudinal studies

“…The characteristics of the included studies are presented in Table . Five studies provided data from a combined population of 3086 subjects in 3 countries Mexico, Japan, and UK . The number of participants ranged from 322 to 1151.…”

Chewing ability and oral health‐related quality of life in frail elders after new complete dentures insertion: A paired controlled clinical trial

“…Oral health problems, such as dry mouth, dental caries, periodontal disease, and edentualism, are widely prevalent in elderly people and can affect one's food choices, swallowing, nutritional intake, speech, and social life, thereby unsettling several aspects of well‐being . FP‐associated loss in muscle mass reduces bite force and disrupts masticatory function, which can hinder food comminution .…”

“…The masticatory function of edentulous elderly people can be impaired the lack of dental prostheses or use of misfitted ones due to insufficient bite force and ability to grind food . Thus, frailty is considered as an aggravating factor in the aging process, and its incidence is increased in edentulous patients …”