Association between oral frailty and well-being in community-dwelling older adults in Japan

The epidemiological mechanisms linking poor oral health and oral function to declining well-being among older adults remain unclear. This study examined the association between oral frailty and well-being among community-dwelling older adults in Japan and explored potential mediating pathways across the physical, psychological, and social domains.

Data were drawn from the 2023 wave of the Itabashi Longitudinal Study on Aging, including participants aged ≥70 years. Oral frailty was assessed using the Oral Frailty 5-item Checklist. Generalized structural equation modeling (GSEM) was used to estimate the indirect effects of oral frailty on well-being, measured using the Philadelphia Geriatric Center Morale Scale (PGCMS) and the Cantril Self-Anchoring Striving Scale (CSASS), through physical frailty, undernutrition, depressive symptoms, cognitive impairment, and social isolation.

A total of 849 older adults (503 men and 346 women; mean age = 75.8 years) were analyzed. The prevalence of oral frailty was 40.2%. The PGCMS showed significant indirect associations between oral frailty and two candidate mediators in the GSEM: undernutrition (b = -0.27, 95% confidence interval [CI]: -0.54 to -0.01) and depressive symptoms (b = -1.35, 95% CI: -1.96 to -0.74). Similar findings were observed for the CSASS, with depressive symptoms (b = -0.66, 95% CI: -0.96 to -0.36) and social isolation (b = -0.14, 95% CI: -0.25 to -0.03) emerging as significant mediators.

Oral frailty is indirectly associated with poorer well-being in older Japanese adults, with GSEM estimates suggesting biological and social pathways involving nutritional status, mental health, and social engagement.