Oral Frailty and Its Association With Frailty Status in Older Adults: Evidence From a Multicentre Study

This study used a novel multidimensional oral frailty assessment tool (OFAT), systematically exploring the relationship between oral frailty in the elderly and closely related oral health factors and frailty status, and analyze the evolution of frailty-related oral characteristics in different age groups, aiming to support early identification and intervention strategies.

A cross-sectional study was conducted among 773 community-dwelling and institutionalised older adults in Beijing, China, from July 2024 to June 2025. Oral frailty was assessed using the OFAT and the Five-item Oral Frailty Checklist. Nine oral health markers were evaluated. Frailty status was determined using the FRAIL scale. Logistic regression models were applied to examine associations, and stratified analyses were performed by age group.

Oral frailty assessed by the OFAT scale was significantly associated with frailty status (p = 0.008) after adjustment for demographic and health-related variables. Among oral health factors, decreased occlusal force emerged as an independent risk factor for frailty status (p = 0.002). Age-specific analyses revealed shifting oral health risk patterns: decreased occlusal force was most relevant in the 60-69 age group, chewing function and self-reported chewing and swallowing difficulties were predominant in the 70-79 age group, and self-reported chewing and swallowing difficulties were most prominent in those aged 80 years and above. The OFAT showed modest predictive accuracy (AUC = 0.626).

Oral frailty is related to frailty status, and the OFAT scale has the potential for further development and application in evaluating oral frailty. Reduced occlusal force is an independent risk factor for frailty status, and self-reported chewing and swallowing difficulties become increasingly important in advanced age. Integrating oral frailty screening into elder care may improve early frailty status detection and intervention.