Oral frailty and its determinants in older age: a systematic review

Abstract

Poor oral health is common among older adults and can impair essential activities of daily living and contribute to frailty. We did a systematic review of studies on the relationship between oral health factors and frailty among older adults (>60 years), consulting six different electronic databases for studies published from database inception to March 20, 2021. In total, 39 articles met the eligibility requirements, including 12 different indicators of poor oral health related to frailty, which we grouped in four different categories: oral health status deterioration; deterioration of oral motor skills; chewing, swallowing, and saliva disorders; and oral pain. Factors of oral health status deterioration (52%), in particular few remaining teeth (29%), were most frequently associated with frailty. Reduced oral motor skills (27%), especially masticatory function (9%), oral diadochokinesis (5%), occlusal force (7%), and chewing, swallowing, and saliva disorders (20%), especially chewing difficulties [11%]), were less frequent but were similarly considered to be associated with frailty. Our findings could help to assess the contribution of each oral health item to a possible operational definition of this novel frailty phenotype, defined as an age-related gradual loss of oral function together with a decline in cognitive and physical functions.

Associations Between Oral Health Status, Perceived Stress, and Neuropsychiatric Symptoms Among Community Individuals With Alzheimer's Disease: A Mediation Analysis

“…Emerging evidence suggests a link between AD and oral health, based on self-reported oral health-related quality of life (OHRQoL), objective indicators of oral health clinical assessments (e.g., missing teeth and gingival bleeding) (Ericsson et al, 2009 ; Zuluaga et al, 2012 ), and other indicators, including oral microbiota (Sureda et al, 2020 ), active potent neuroinflammatory regulators (e.g., IL-1β, IL-6, and TNF-α) (El Idrissi et al, 2021 ), and high salivary cortisol levels (Venturelli et al, 2016 ). An age-related change of oral status together with a decline in cognitive may be defined as a state of oral frailty (Dibello et al, 2021 ), representing toothache, oral dryness, tooth loss, dental caries, periodontal disease, and a set of worse oral daily practice functions, which may result in psychological distress (Vasiliou et al, 2016 ; Turner et al, 2017 )and behavioral disturbances (Park et al, 2014 ; Kubo et al, 2017 ; Dahl et al, 2018 ). These oral clinical symptoms may eventually evolve into new stressors, thereby affecting disease outcomes (Mariño et al, 2020 ).…”

Role of Dietary Carotenoids in Frailty Syndrome: A Systematic Review

“…Consistently acknowledged as a markedly reduced physiological reserve of adaptive capacity to cope with stresses [2], frailty affects multiple domains of human functioning. Its multidimensional nature requires a challenging multidisciplinary approach [3,4] across the spectrum of sensory, physical, social, cognitive, oral, psychological/depressive, and nutritional phenotypes [5][6][7][8].…”

Oral hypofunction and its relation to frailty and sarcopenia in community‐dwelling older people

“…[5][6][7][8] However, these studies have evaluated only one or a few aspects of oral function; thus, a comprehensive evaluation of all aspects of oral function, and their effects on frailty, is required. 9 In 2016, the Japanese Society of Gerodontology (JGS) established the criteria for assessing oral hypofunction using seven oral functions. 10 They selected seven conditions (poor oral hygiene, oral dryness, reduced occlusal force, decreased tongue-lip motor function, decreased tongue pressure, decreased masticatory function and deterioration of swallowing function) for the diagnosis of oral hypofunction and also established the initial thresholds for use as diagnostic criteria for these conditions.…”