Association between oral health and physical frailty in community-dwelling older adults: A systematic review and meta-analysis

Abstract

Objective: Oral health and function are increasingly recognized as important determinants of overall health in the older population. This systematic review aimed to synthesize current pieces of evidences on how various oral factors are associated with the onset and progression of physical frailty in community-dwelling older adults. Methods: A comprehensive literature search was conducted using Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. Studies including community-dwelling adults aged 50 years or older with oral health-related measures and physical frailty were included. Meta-analyses were performed, and sensitivity and subgroup analyses were conducted to validate the findings. The quality of studies was evaluated using the Risk of Bias for Nonrandomized Studies version 2.0. tool. Results: Twenty-five articles involving 63,842 adults were selected. The parameters related to the masticatory and swallowing function and oral dryness demonstrated significant associations with physical frailty. Meta-analyses revealed significant associations of physical frailty with having fewer than 20 teeth (OR 2.62, 95 % CI [1.95-3.53]), subjective swallowing difficulty (OR 2.48, 95 % CI [1.70-3.60]), edentulism (OR 2.04, 95 % CI [1.59-2.61]), subjective masticatory difficulty (OR 2.02, 95 % CI [1.64-2.50]), subjective perception of dry mouth (OR 1.97, 95 % CI [1.61-2.41]), and perceived oral health status (OR 1.66, 95 % CI [1.59-1.73]). Conclusions: This systematic review demonstrated that poor oral health and impaired oral function were significantly associated with physical frailty among older adults. These findings strongly support incorporating oral health screenings into routine geriatric assessments to identify older adults at risk of physical frailty and to inform targeted preventive strategies.