Impact of Subjective Masticatory Difficulty on Malnutrition and Frailty in Community-Dwelling Older Adults

Abstract

Objectives: This study evaluated the impact of masticatory difficulty on the development and progression of malnutrition, frailty, sarcopenia, and disability in community-dwelling adults, using data from the Korean Frailty and Aging Cohort Study.

Methods: Participants were categorised by presence of masticatory difficulty. The Fried frailty phenotype, mini-nutritional assessments, and diagnostic criteria proposed by Asian Working Group on Sarcopenia were adopted to diagnose frailty, malnutrition, and sarcopenia respectively. Physical disabilities were measured using the Korean activities of daily living (ADL) and Korean instrumental activities of daily living (IADL) scales.

Results: A total of, 3010 participants were initially enrolled, 2864 participants remained in the study after 2 years, reflecting a 95.1% retention compliance. At baseline, the prevalence of frailty (28.0% vs. 18.1%), malnutrition (1.5% vs. 0.8%), IADL disability (10.1% vs. 7.7%), and ADL disability (10.8% vs. 8.0%) was higher among those experiencing masticatory difficulty than in those without. After 2 years, baseline masticatory difficulty was associated with the incidence of malnutrition (OR, 2.62; 95% CI, 0.99-6.90; p = 0.042) after full adjustment for confounders. However, no associations were found between baseline masticatory difficulty and the incidence of frailty, sarcopenia or physical disability over 2 years after adjustment. Additionally, masticatory difficulty did not affect the persistence or remission of malnutrition, frailty, sarcopenia, IADL disability, and ADL disability in individuals who already had these conditions at baseline.

Conclusion: Restoring chewing function and masticatory satisfaction improves not only oral health but also contributes to overall health and promotes healthy aging in older individuals.