Physical function and oral frailty severity: A cross-sectional study

This study aimed to examine the association and predictive value of physical function to oral frailty severity among community-dwelling older Korean adults.

From October 2024 to June 2025, 138 older adults in the community were recruited from senior centers. Oral frailty, assessed using six items, and classified by severity (robust [0-1], pre-frailty [2], frailty [≥3]) and dichotomized at cutoffs (≥2 or≥3 impairments). Physical indicators included Kihon checklist (KCL), skeletal muscle mass, handgrip strength (HS), physical performance (PP), and body mass index (BMI). Latent class analysis (LCA), multinomial and multivariable logistic regression, and the area under the receiver operating characteristic curve (AUC) analyses were performed.

Pre-oral frailty was significantly associated with higher KCL scores (adjusted odds ratio [AOR] = 1.17; 95 % confidence interval [CI] 1.002-1.366). In oral frailty, HS and PP had AORs of 0.835 (95 % CI 0.727 - 0.960) and 1.215 (95 % CI 1.013 - 1.457), respectively, while BMI showed an AOR of 0.798 (95 % CI 0.673 - 0.947). At a cutoff of ≥3 impairments, both HS and PP demonstrated strong discriminative ability for oral frailty, with significant associations (AORs: 0.896 and 1.173) and high AUCs (0.787 and 0.813). LCA revealed two groups: robust type (Class 1; 29.71 %) and oral frailty type (Class 2; 70.29 %). The KCL score was significantly associated with Class 2 (AOR = 1.159, 95 % CI 1.019-1.369), with AUC of 0.834 CONCLUSION: Subjective frailty, weak grip strength, poor physical performance, and low BMI were positively related to oral frailty severity.

Our findings underscore the clinical importance of assessing key physical indicators-including subjective frailty, grip strength, physical performance, and BMI-as practical tools for identifying oral frailty severity in older adults. Identifying these markers may guide early interventions to alleviate oral frailty progression and ultimately enhance quality of life.