Oral Frailty and Multidimensional Health Among Community-Dwelling Older Adults in China: A Cross-Sectional Study

Background/Objectives: Oral frailty is increasingly recognized as an age-related decline in oral function and a potential marker of broader health vulnerability. However, its association with multidimensional health within a standardized healthy aging framework remains insufficiently characterized. This study aimed to examine the association between oral frailty and multidimensional health among community-dwelling older adults in China using the WS/T 802-2022 healthy aging framework. Methods: This community-based cross-sectional study included 454 adults aged 60 years or older from Chenzhou, Hunan Province, China. Oral frailty was primarily assessed using the Oral Frailty Index-8 (OF-8), with the Screening Tool for Oral Frailty-6 (SOFT-6) used as an alternative definition. Overall, physical, mental, and social health were evaluated according to WS/T 802-2022. Associations were examined using ordinal regression models, supplemented by sensitivity and dose-response analyses. Results: Oral frailty was common, with prevalence estimates of 59.1% by OF-8 and 52.3% by SOFT-6. Compared with participants without oral frailty, those with OF-8-defined oral frailty were older and had lower body mass index, lower skeletal muscle mass index, lower grip strength, greater chronic disease burden, fewer remaining natural teeth, and lower overall and physical health scores. In the main adjusted model, OF-8-defined oral frailty was associated with lower odds of being in a better overall health category (odds ratio [OR] = 0.554, 95% confidence interval [CI]: 0.374-0.822). For physical health, threshold-specific estimates from partial proportional odds models were directionally consistent but did not reach statistical significance. The association with social health was nominal, whereas the association with mental health was not statistically significant. Across sensitivity analyses, estimates for overall health were directionally consistent, whereas domain-specific findings varied across alternative oral-frailty definitions and analytical approaches. In sensitivity analyses excluding participants with extreme total energy intake, the association with overall health remained statistically significant, whereas the associations with physical and social health were attenuated and no longer reached conventional statistical significance. Restricted cubic spline analyses showed approximately monotonic inverse associations between OF-8 score and overall, physical, and mental health scores, without evidence of significant nonlinearity. Oral frailty was highly prevalent and was associated with poorer multidimensional health, particularly overall health, among community-dwelling older adults. Conclusions: These findings suggest that oral frailty, assessed with OF-8, may be a simple, nutrition-relevant indicator that could help flag community-dwelling older adults for fuller multidimensional geriatric assessment. Because the design was cross-sectional and associations beyond overall health were inconsistent, the screening or predictive performance of oral frailty was not formally evaluated and requires confirmation in longitudinal, multicenter studies.