Association Between Oral Health and Frailty in Older Korean Population: A Cross-Sectional Study

Abstract

Frailty is closely associated with biological age, concurrent medical conditions, morbidity, and decreased survival. Poor oral health is common in older individuals and is associated with frailty. Considering its potential importance, a study on the association between oral health and frailty is meaningful. Therefore, we aimed to analyze the association between major oral health factors and frailty using nationally representative samples of older adults. Patients and Methods: This cross-sectional study included 3018 older adults (age ≥ 65 years) from the seventh Korea National Health and Nutrition Examination Survey. Oral examination results, laboratory data, handgrip strength, life style factors derived from questionnaires, and food intake survey results were analyzed. This study used the deficit accumulation model among the main operational definitions of frailty. We constructed a frailty index based on 36 items and classified participants as non-frail, pre-frail, or frail. Oral health factors included chewing difficulty, number of teeth, periodontal disease, and number of carious teeth. Logistic regression analysis was performed to determine significant factors. Results: A total of 1222 (40.5%), 1014 (33.6%), and 782 (25.9%) individuals were classified as non-frail, pre-frail, and frail, respectively. Chewing difficulty was associated with increased risk of frailty after adjusting for age, sex, socioeconomic factors, and comorbidities (odds ratio 2.68, 95% confidence interval 2.08-3.44). Periodontal disease was positively associated with chewing difficulty (odds ratio 1.29, 95% confidence interval 1.07-1.56), and chewing difficulty decreased as the number of teeth increased (odds ratio 0.97, 95% confidence interval 0.96-0.99). Conclusion: Chewing difficulty was significantly associated with frailty in the older population. Considering the negative effect of chewing difficulty on frailty, more attention should be focused on oral health.

Malnutrition as a major related factor of frailty among older adults residing in long-term care facilities in Korea

“…However, the previous study was a retrospective review of frailty among participants who died in the LTCH, so it can be assumed that they were more frail than the participants of this study. The prevalence of frailty in this study is higher than the 25.9% reported among Korean older adults living in the community [20], which supports the results of previous studies [3, 5, 6]. The prevalence of dry mouth in this study was 17.6%, which is similar to a previous study [21].…”

“…Oral health is closely related to frailty, with frail older adults having a higher rate of complaint about dry mouth than robust older people. The results of this study are similar to those of previous studies that reported that frail older adults had poorer oral health (e.g., chewing difficulty, general oral health) than robust older adults [20,22]. The prevalence of malnutrition (including those malnourished and at risk for malnutrition) in this study was 75.8%.…”

“…These findings are consistent with the results of previous studies [7,43]. A systematic review reported that oral health is closely related to frailty [43], and similar results have been reported in studies of Korean older adults [20,22]. Lim and colleague reported that poor oral health status increased the risk of frailty and various geriatric syndromes [22].…”

“…Lim and colleague reported that poor oral health status increased the risk of frailty and various geriatric syndromes [22]. Another study not only reported that perceived chewing difficulty increased the incidence of frailty, but also that frailty is a predictor of poor oral health [20]. In other words, poor oral health is both a result and driving force in the vicious cycle of frailty progression [20], and can be a major cause of poor outcomes.…”

“…Another study not only reported that perceived chewing difficulty increased the incidence of frailty, but also that frailty is a predictor of poor oral health [20]. In other words, poor oral health is both a result and driving force in the vicious cycle of frailty progression [20], and can be a major cause of poor outcomes. In this study, dry mouth was identified as the second most important factor in frailty.…”