Oral Frailty, Dental Visits, and Healthy Life Expectancy: A 6-Year Prospective Cohort Among Japanese Older Adults

Oral frailty (OF), a comprehensive oral function decline, is linked to health deterioration in older adults. The impact of OF and dental visits on healthy life expectancy (HLE) remains underexplored. This study examined the association between OF, dental visits, and HLE.

This prospective cohort study used data from the 2016 Japan Gerontological Evaluation Study (JAGES), including independent older adults aged ≥ 65 at baseline, with follow-up through March 2023 using disability and mortality records from the national long-term care insurance database (median follow-up = 6.2 years). OF was defined as having ≥ 3 of the following: fewer teeth, chewing difficulty, swallowing difficulty, dry mouth, and speaking difficulty. Recent dental visits at baseline were assessed. HLE by OF status and dental visits was estimated using Royston-Parmar multistate modeling in random forest-imputed datasets, adjusting for sociodemographic and health confounders.

Among 11 080 participants (mean age 74.1; 52.9% female), 12.0% were OF, and 49.5% had a dental visit in the past 6 months. OF was associated with transition from healthy to disability (hazard ratio [HR]: 1.23, 95% confidence interval [95% CI]: 1.01-1.50) and from healthy to death (HR: 1.34, 95% CI: 1.05-1.71). At age 65, males without OF had an HLE of 23.39 years, while males with OF had 21.96 years; females without OF had an HLE of 24.77 years, while females with OF had 23.64 years. Dental visits were associated with approximately 1 year longer HLE in all groups.

OF significantly reduces HLE, and dental visits may mitigate this outcome in older adults.