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Oral Frailty, Social Frailty, and 6-Year Risk of Long-term Care Onset
I Susanti1,2, H Abbas2, K Takeuchi2,3
1Department of Community Dentistry of Chulalongkorn University, Bangkok, Thailand.
JDR Clinical and Translational Research
|July 3, 2026
Summary
Oral frailty, a decline in oral health, significantly increases the risk of needing long-term care (LTC) in older adults. This association is partly mediated by social frailty, highlighting the importance of oral health for aging well.
Area of Science:
- Gerontology and Public Health
- Oral Health and Aging
- Social Determinants of Health
Background:
- Oral frailty is a growing concern among community-dwelling older adults.
- Understanding predictors of long-term care (LTC) onset is crucial for public health strategies.
- The interplay between oral health, social factors, and care dependency requires further investigation.
Purpose of the Study:
- To examine the longitudinal relationship between oral frailty and the onset of long-term care (LTC) dependency.
- To investigate the mediating role of social frailty (SF) in the association between oral frailty and LTC onset.
- To analyze data from community-dwelling older adults aged 65 years and above in Japan.
Main Methods:
- A 6-year longitudinal study using data from the Japan Gerontological Evaluation Study (JAGES) (2013-2022).
- Oral frailty was categorized into robust, pre-oral frail, and oral frail groups.
- Logistic regression and causal mediation analyses were employed to assess the relationship and mediation by SF.
Main Results:
- Oral frailty was significantly associated with an increased likelihood of LTC onset (OR=1.47 for oral frail; OR=1.39 for pre-oral frail).
- Social frailty mediated 7% to 19% of the association between oral frailty and LTC onset.
- A dose-response gradient was observed, with more severe oral frailty linked to higher LTC risk.
Conclusions:
- Oral frailty is a significant predictor of long-term care dependency in older adults.
- Social frailty partially explains the pathway through which oral frailty leads to care dependency.
- Maintaining oral health and social engagement are vital for healthy aging and preventing care dependency.
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