The Need for Oral Frailty Prevention and Future Tasks

Objectives: To review the concept of oral frailty and the available evidence and propose priorities for community-based prevention and management in the Republic of Korea (ROK). Methods: This narrative review examined studies and government and public agency reports on definitions, screening and diagnosis, epidemiological characteristics, interventions, and policy linkages. Findings were organized into four themes. Results: Oral frailty is a potentially reversible intermediate state between normal oral function and oral hypofunction. It is associated with physical frailty, sarcopenia, and mortality and affects approximately one-third of community-dwelling older adults in pooled international estimates. It may precede physical frailty, can be identified using self-reported questions, and may provide information on nutritional pathways that conventional frailty assessments do not adequately capture. In the ROK, self-reported screening items have been proposed, but their reliability when administered by community personnel remains unestablished, while confirmatory assessment relies on specialized devices. Korean intervention evidence consists mainly of small, single-site pre-post studies and case reports. This review identified no Korean empirical studies demonstrating that oral frailty interventions improve physical frailty. Linkages between local health programs and national oral health policy remain at the pilot stage. Conclusions: Four priorities are proposed: incorporate oral frailty screening and assessment into community frailty assessment and link identified needs to nutrition and muscle-strengthening care; integrate and standardize existing self-reported items, evaluate inter-rater agreement, test-retest reliability, and field acceptability among non-specialists, and refer only those at risk for professional assessment; adapt internationally supported interventions to the ROK delivery system and assess oral function, frailty, nutrition, and muscle strength in multicenter studies; and link local health programs with national policy through referral pathways and screening arrangements.