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Updated: Jan 16, 2026
Oral Health Assessment by Lay Personnel for Older Adults
Published on: February 2, 2020
Relationship Between Oral Frailty Index-8 Cutoff Values and Dysphagia in Older Patients With Hip Fracture: A
Yoshihiro Watanabe1, Yoichi Sato1, Toshiaki Tamura2
1Department of Rehabilitation, Uonuma Kikan Hospital, Minamiuonuma, Japan.
Background:
Early detection of dysphagia, which is frequent in older patients with hip fractures, is challenging. Oral frailty, reflecting age-related decline in oral function, may serve as an early indicator of dysphagia risk.
Objectives:
To evaluate whether preoperative oral frailty, assessed by the Oral Frailty Index-8 (OFI-8), is associated with dysphagia and to determine the optimal OFI-8 cutoff for predicting it.
Methods:
This single-centre retrospective cohort study included 130 patients ≥ 65 years with hip fractures. Preoperative oral frailty was assessed using OFI-8. Dysphagia at discharge was defined as a Functional Oral Intake Scale score ≤ 5. Logistic regression analysis with Firth's penalised likelihood method was performed to evaluate associations between dysphagia risk and both oral frailty status (present/absent) and OFI-8 scores. Receiver operating characteristic (ROC) analysis was conducted to determine the optimal OFI-8 cutoff.
Results:
Dysphagia was observed in 10.0% (13/130) of the patients. None of the patients without oral frailty developed dysphagia, whereas 13.8% of those with oral frailty did (p = 0.019). Higher OFI-8 scores were significantly associated with increased dysphagia risk (odds ratio = 1.81; 95% confidence interval [CI]: 1.27-2.98; p < 0.001). ROC analysis identified an OFI-8 cutoff of 7, with an area under the curve of 0.886, sensitivity 92.3%, and specificity 72.6%. Severe oral frailty (OFI-8 ≥ 7) was strongly associated with dysphagia (odds ratio = 13.35; 95% CI: 2.80-130.87; p < 0.001).
Conclusion:
Higher OFI-8 scores and severe oral frailty are independently associated with dysphagia risk.
