Frailty, Frailty Components, and Oral Health: A Systematic Review

Abstract

A systematic review was conducted to assess the relationship between frailty or one of its components and poor oral health. A search strategy was developed to identify articles related to the research question in the PubMed, EMBASE, Cochrane, LILACS, and SciELO databases that were published in English, Spanish, or Brazilian Portuguese from 1991 to July 2013. Thirty-five studies were identified, and 12 met the inclusion criteria, seven of which were cross-sectional and five were cohort studies. Of the 12 articles, five (41.7%) were rated good and seven (58.3%) as fair quality. The published studies applied different oral health and frailty criteria measures. Variations in definitions of outcome measures and study designs limited the ability to draw strong conclusions about the relationship between frailty or prefrailty and poor oral health. None of the studies that were evaluated longitudinally showed whether poor oral health increases the likelihood of developing signs of frailty, although the studies suggest that there may be an association between frailty and oral health. More longitudinal studies are needed to better understand the relationship between frailty and oral health.

Oral health and dental care of older persons—A systematic map of systematic reviews

“…Epidemiological data show that many older persons retain their natural dentitions, with a high number of remaining teeth . Moreover, advanced prosthodontic reconstructions, such as osseointegrated implants, have become more common and removable appliances are decreasing …”

Oral status, cognitive function and dependency among New Zealand nursing home residents

“…Poor oral health in older age can also have systemic health consequences, being an important risk factor for aspiration pneumonia in frail older people, and subsequent hospital admissions. Poor oral health may also contribute to frailty through its negative effects on fluid and protein intake . Overall, this situation presents a major clinical and public health problem which is going to get worse as more and more old people enter aged residential care with their own teeth; neither the aged care sector nor the dental profession (in most countries) is prepared…”

Handgrip strength and the number of teeth among Korean population

“…Objective measures of physical performance, such as handgrip strength, walking speed, and standing balance, are widely used to assess frailty . In particular, handgrip strength is a powerful marker of sarcopenia and frailty among the elderly . Systematic reviews and prospective studies have demonstrated that handgrip strength predicts subsequent physical health problems, cognitive decline, and all‐cause mortality …”

“…found a significant association between the number of teeth and handgrip strength in men. A systematic review recently demonstrated that the association between the number of teeth and handgrip strength was inconclusive . Most previous studies were based on elderly populations, so it is difficult to generalize the results because of insufficient sample size .…”