Oral Health as a Predictor of Physical Frailty among Rural Community-Dwelling Elderly in an Agricultural County of Taiwan: A Cross-Sectional Study

Abstract

We conducted a cross-sectional study to clarify the relationship between oral health and physical frailty (PF). A sample of 903 community-dwelling individuals aged ≥ 65 years were enrolled from random communities in Chiayi County. The self-perceived oral health (SPOH) and oral health assessment tool (OHAT), which consists of eight items, was used for the evaluation of their oral health status. PF was assessed based on the Study of Osteoporotic Fracture index. Overall, 14.6% of the participants had PF. In an adjusted model, restricted food types (odds ratio (OR) = 1.59, 95% confidence interval (CI): 1.2–2.09, p = 0.001), self-reported dental status (OR = 1.61, 95% CI: 1.2–2.15, p = 0.001), number of teeth (OR = 0.98, 95% CI: 0.96–0.99, p = 0.006), frequency of tooth cleaning (OR = 0.83, 95% CI: 0.68–1.0, p = 0.049), OHAT score (OR = 1.09, 95% CI: 1.02–1.17, p < 0.017), and saliva items of OHAT (OR = 1.52, 95% CI: 1.11–2.1, p = 0.010) were significantly associated with PF. SPOH is a crucial indicator of PF; longitudinal analyses are necessary to understand the underlying pathway of risk factors for frailty onset.

Association between Oral Frailty and Physical Frailty among Rural Middle-Old Community-Dwelling People with Cognitive Decline in Taiwan: A Cross-Sectional Study

“…Self-reported health status levels of fair and poor were also found to be indispensable predictors for PF in this study. Self-perceived oral health with restricted food types and dental status was significantly associated with PF [ 35 ]. Elderly people with cognitive decline may require guidance for self-reported oral frailty problems, which could improve their oral health.…”

The association between the number of teeth and frailty among older nursing home residents: a cross-sectional study of the CLHLS survey

“…Our study found that there was a significant association between tooth loss and a greater likelihood of frailty among older nursing home residents, which was in line with previous studies. In a study covering 903 community-dwelling older adults, the number of teeth was associated with frailty, with an OR = 0.98 (95% CI: 0.96-0.99) [17]. In addition, a cohort study with 3 years of follow-up among home-dwelling individuals aged 70 or older indicated that one additional tooth could lower the risk of frailty by 5.0% [14].…”

“…In 2013, Andrade and colleagues explored the association between oral health and frailty among older community-dwelling adults, and the results showed that participants with 20 or more teeth had a lower likelihood of being frail than those with edentulism [12]. In recent decades, a growing body of studies have indicated that tooth loss leads to a high risk of frailty in both cross-sectional and prospective cohort studies [13][14][15][16][17]. In addition, studies have also found that poor oral behavior can lead to a high risk of frailty among community-dwelling older adults.…”

The association between the number of teeth and frailty among older adults: a systematic review and meta-analysis

“…To date, multiple studies have explored the relationship between the number of teeth and frailty. However, the relationship remains uncertain, and whether the risk of frailty increases as the number of teeth decreases is a matter of debate 9,10 . Some studies have linked decreasing in the number of teeth to the risk of frailty in old adults, one of the biggest medical challenges facing older adults today 1,[11][12][13][14] .…”

“…The pathways between number of teeth and frailty may be nutrition, in ammation and so on 1 .The decrease in the number of teeth can reduce the chewing function of older adults, thus affecting their food choices and causing them to avoid eating hard foods that are di cult to chew 9 . As a result, with lower intake of fruits, vegetables, and proteins, the risk of malnutrition increases and therefore, frailty comes 10 .…”