The Relationship of Oral Health with Progression of Physical Frailty among Older Adults: A Longitudinal Study Composed of Two Cohorts of Older Adults from the United Kingdom and United States

The association between the number of teeth and frailty among older adults: a systematic review and meta-analysis

BACKGROUND

Tooth loss is common among the elderly and often correlates with aging. Existing studies on the link between tooth loss and frailty in older adults yield inconsistent results. This systematic review and meta-analysis aims to clarify the relationship.

METHODS

A comprehensive search of PubMed, Web of Science, Embase, and Cochrane Library was conducted to find observational studies on tooth count and frailty in older adults. Study quality was assessed using the Newcastle-Ottawa scale. Heterogeneity was evaluated using Cochran's Q and I² statistics, and subgroup analyses identified factors influencing outcomes. Publication bias and sensitivity analysis confirmed result stability.

RESULTS

From 1,903 articles, 22 comprising 25 studies with 36,406 participants were included. The meta-analysis showed a pooled odds ratio (OR) of 0.98 (95% CI: 0.97 - 0.99) for tooth count and frailty. Individuals with 20 or fewer teeth had a higher risk of frailty (pooled OR = 1.99, 95% CI: 1.57 - 2.53). The highest frailty risk was observed in Japan (pooled OR = 3.02), followed by China (2.27), the UK and USA (1.90), and other regions (1.25). Subgroup analyses revealed no significant differences by country, study design, setting, adjustment model, or frailty assessment tool (P > 0.05).

CONCLUSIONS

There is a significant association between tooth count and frailty, particularly in those with 20 or fewer teeth. Policymakers should prioritize oral health within aging populations by promoting early preventive care and education to mitigate frailty risk. Robust, large-scale studies are needed to guide evidence-based interventions and public health policy.

Association between tooth loss and geriatric syndromes in older adults: a cohort study from a rural area in eastern China

BACKGROUND

Tooth loss was linked to health status, with substantial implications for malnutrition and chronic inflammation risks in older adults, especially among vulnerable groups. This study aimed to explore the associations between tooth loss severity, denture status, and geriatric syndromes.

METHODS

In 2019, 1094 participants were recruited and subjected to face-to-face interview to assess tooth loss severity, along with grip strength and body composition. In 2023, a follow-up was conducted with a subsample of the participants. Logistic regression analysis was utilized to explore the association between tooth loss severity at baseline and geriatric syndromes (sarcopenia, malnutrition risk, frailty, fall) at fourth year follow-up, as well as association between denture status and geriatric syndromes.

RESULTS

The multivariate analyses showed that having tooth loss affecting daily life at baseline was associated with a 1.80-fold higher prevalence of sarcopenia and 2.31-fold higher prevalence of malnutrition risk after four years. Participants with fewer than 10 teeth had significantly higher odds of geriatric syndromes compared to those with 21 or more teeth: 1.87-fold for sarcopenia (95% CI: 1.07 to 3.26), 2.99-fold for malnutrition risk (95% CI: 1.93 to 4.62), and 1.68-fold for frailty (95% CI: 1.10 to 2.56). Older adults with tooth loss who did not have dentures exhibited a significantly higher odds of sarcopenia, malnutrition risk, frailty, and falls, more number of geriatric syndromes.

CONCLUSION

Higher severity level of tooth loss at baseline were associated with higher odds of geriatric syndromes at fourth year in older adults. Dentures partially mitigate the association between tooth loss and the higher odds of geriatric syndromes. Screening and intervening oral health is important for the prevention of geriatric syndromes in older adults.

CLINICAL TRIAL NUMBER

Not applicable.

Examining the Impact of Natural Teeth Trajectory on Mortality Among CLHLS

BACKGROUND

To investigate the associations between trajectories of the number of natural teeth and all-cause mortality among Chinese middle-aged and older adults.

METHODS

Data for this study were sourced from the 2002, 2005, 2008, 2011, 2014, and 2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). The number of natural teeth was assessed through self-reports. Population-based trajectory models were utilised to explore potential heterogeneity in longitudinal changes over 16 years and to examine the associations between baseline predictors and different trajectories among cohort members. Additionally, the Cox proportional hazards model was employed to assess the risk factors associated with these trajectories.

RESULTS

Three distinct trajectories in the number of natural teeth were identified: fewer teeth (33.34%), a moderate number of teeth (47.58%), and most teeth retained (19.08%). Several factors were found to influence changes in these trajectories: older age, male gender, poor self-reported health status, impaired vision, a higher number of chronic diseases, diminished cognitive function, and reduced frequency of social activities. Compared to the group with fewer teeth, those with moderate and most teeth demonstrated a better prognosis.

CONCLUSION

The number of natural teeth is associated with mortality, and retaining more natural teeth may play a significant role in promoting healthy aging.

Joint association of objective and subjective aging with premature mortality

Objective and subjective aging indicators reflect diverse biological and psychosocial processes, yet their combined association with premature mortality remains underexplored. This study aimed to investigate the association between a multidomain framework of aging indicators and premature mortality, addressing gaps in understanding cumulative effects. We included 369,741 UK Biobank participants initially free of cardiovascular disease (CVD) and cancer, followed until December 31, 2022. Four indicators, hearing loss, tooth loss, falls and subjective aging, were counted, and their joint associations with all-cause and cause-specific premature mortality were analyzed using the Cox proportional hazard models. During a median follow-up of 13.74 years, we documented 22,934 premature mortality. Participants with all indicators had an 81% (95%CI: 59-107%), 96% (47-160%), 55% (26-91%), and 114% (73-165%) higher risk of all-cause, CVD, cancer, and other-cause premature mortality, respectively, compared to those without indicators. The associations were particularly elevated among younger participants, those with unhealthy lifestyles, and those of lower socioeconomic status (P for interactions <0.05). Additive interaction with frailty contributed an additional 16.08% (7.91-24.25%) risk of premature mortality. Findings were replicated in the Health and Retirement Study, supporting the robustness of the multidomain aging framework. This study highlights the potential of integrating objective and subjective aging indicators to refine risk assessments and inform interventions targeting aging-related diseases.

Association Between Physical Function and Edentulism in Older Adults: Findings from the Indonesian Family Life Survey 2014

This study aimed to determine the association between physical function and edentulism among older adults. The fifth wave of Indonesian Family Life Survey (IFLS-5) data was used. Physical function was evaluated through physical performance, physical capability, and appendicular skeletal muscle mass (ASM). Edentulous was found in 10.96% of 2554 older adults. Low physical performance (OR 2.02, 95% CI 1.32-3.09; P = .001) was shown to be associated with edentulism in the 60 to 69 age group. In the 70 to 79 age group, both low physical performance (OR 1.62, 95% CI 1.04-2.53; P = .033) and 1 dependency in ADL/IADL (OR 1.75, 95% CI 1.02-2.98; P = .04) were significantly associated with edentulism. Two or more dependencies in ADL/IADL (OR 4.02, 95% CI 1.15-13.99; P = .029) demonstrated significant association with edentulism in older adults ≥80 years. These findings highlighted the importance of maintaining natural teeth and improving oral health during the aging process.

Prevalence and unfavourable outcome of oral frailty in older adult: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVE

Oral frailty (OF) refers to a decline in oral function amongst older adult that often occurs alongside declines in cognitive and physical abilities. We conducted a study to determine the prevalence and unfavourable outcomes of OF in the older adult population to provide medical staff with valuable insights into the associated disease burden.

METHODS

From inception to March 2024, we systematically searched six key electronic databases: PubMed, Web of Science, Embase, Cochrane Library, Scopus, and CINAHL to identify potential studies that reported the prevalence or unfavourable outcomes of OF amongst older adult. Studies that did not have accessible data were excluded. Two researchers worked independently to retrieve the literature, collect data, and evaluate the quality of the included studies. Data analysis was conducted using R Project 4.1.1 and Review Manager 5.3 software.

RESULTS

We identified 28 studies that met the inclusion criteria, including 27,927 older adult. The pooled prevalence of OF amongst older adult was 32% (95% confidence interval (CI): 0.24, 0.41). Subgroup analyses indicated that the setting, sample, design of studies, and assessment instruments influence the prevalence of OF. In addition, OF was associated with a high risk of physical frailty (odds ratio (OR) = 1.67; 95% CI: 1.38, 2.02), malnutrition (OR = 2.27; 95% CI: 1.75, 2.96), low dietary variety (OR = 1.98, 95% CI: 1.15, 3.39), and social withdrawal (OR = 1.42; 95% CI: 1.18, 1.71).

CONCLUSION

This systematic review and meta-analysis revealed that OF is prevalent amongst older adult. OF may affect the prognosis of older adult and thus necessitates comprehensive assessment and management as part of an integrated approach.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=537884.

Relationship between tooth loss and progression of frailty: Findings from the English longitudinal study of aging

OBJECTIVE

The objective of the present study was to investigate the relationship between indicators of oral health status (number of teeth; denture use) and the progression of frailty amongst adults in England.

METHODS

The subjects were participants of the English Longitudinal Study of Aging [ELSA] aged 50 years and older. We used panel data from three waves of the study (Waves 7-9). Indicators of oral health comprised the number of teeth (≥20; 10-19; 1-9; 0) and combination of removable denture usage and the number of teeth. Frailty was assessed by the 32-item Frailty Index (FI). Covariates were age, sex, education, marital status, smoking, alcohol, and physical activity. The longitudinal relationship between oral health indicators and change in FI were investigated using linear mixed-effect models considering frailty as a time-varying variable.

RESULTS

Among the 7,557 participants, compared to those people with 20 or more teeth, change in frailty over time was significantly higher among those with less than 20 teeth: 10-19 teeth (β: 0.249, 95 %CI: 0.116 to 0.382), and 1-9 teeth (β: 0.238, 95 %CI: 0.053 to 0.423) and being edentate (β: 0.286, 95 %CI: 0.106 to 0.465) when adjusting for co-variates. The rise in frailty over time was significantly higher among those with fewer teeth (<20 teeth), including those using dentures.

CONCLUSIONS AND IMPLICATIONS

This longitudinal analysis suggests that tooth loss is associated with accelerated progression of frailty and utilizing dentures did not reduce the trend in frailty. Thus, maintaining a functional natural dentition is important in healthy ageing.

Impact of Masticatory Performance and the Tongue-Lip Motor Function on Incident Adverse Health Events in Patients with Metabolic Disease

AIM

The present study aimed to determine whether decreased masticatory performance and tongue-lip motor function are associated with an increased incidence of adverse health events in patients with metabolic disease.

METHODS

One thousand patients with metabolic diseases including diabetes, dyslipidemia, hypertension, and hyperuricemia were recruited. Masticatory performance was assessed using a gummy jelly test, wherein glucose elution from chewed gummy jelly was measured. The tongue-lip motor function was measured using repeatedly pronounced syllables per second. Their association with the incidence of adverse health events (a composite of all-cause death, cardiovascular disease, bone fracture, malignant neoplasm, pneumonia, and dementia) was investigated using the generalized propensity score (GPS) method.

RESULTS

During a median follow-up period of 36.6 (interquartile range, 35.0-37.7) months, adverse health events were observed in 191 patients. The GPS adjusted dose-response function demonstrated that masticatory performance was inversely associated with the incidence of adverse health events. The 3-year incidence rate was 22.8% (95% confidence interval, 19.0-26.4%) for the lower quartile versus 13.6% (10.5-16.7%) for the upper quartile (P＜0.001). Similarly, the tongue-lip motor function was inversely associated with the incidence of adverse health events, with a 3-year incidence rate of 23.6% (20.0-27.0%) for the lower quartile versus 13.2% (10.4-15.9%) for the upper quartile (P＜0.001).

CONCLUSIONS

Decreased masticatory performance and tongue-lip motor function were associated with an increased incidence of adverse health events in patients with metabolic disease.

Unfavourable Outcomes in Older Adults with Oral Frailty: A Scoping Review

BACKGROUND

The significant occurrence of oral frailty (OF) in older patients highlights the necessity of addressing this concern. OF is associated with complications and mortality in elderly patients. The objective of this study is to identify unfavorable outcomes in older patients with OF to increase awareness and mitigate risks.

METHODS

This review employed specific MeSH terms to perform an extensive literature search on OF and its unfavorable outcomes across PubMed, Web of Science, Embase, Cochrane Library, Scopus, and CINAHL databases. The review included English-language papers published from inception to March 31, 2024, focusing on individuals aged 60 and above, adverse outcomes related to OF, and studies employing cross-sectional or cohort designs.

RESULTS

The review comprised 28 articles: 20 cross-sectional and 8 prospective cohort studies. Among these articles, 10 were rated as "Good" and 18 as "Fair", reflecting the high quality of the literature. Next, 20 OF assessment tools were summarized, and the most frequently used methods for assessing OF were the methods of Tanaka et al and Oral Frailty Index-8 (OF-8). The most frequently unfavorable outcomes related to OF in the elderly were physical frailty, malnutrition, low dietary variety, social withdrawal, disability, and low gait speed.

CONCLUSION

High levels of OF significantly increase the risk of adverse outcomes in older adults, including physical frailty, malnutrition, low dietary variety, social withdrawal, disability, and low gait speed. Effective risk stratification and management are essential to reduce these outcomes.

Poor Oral Health-Related Quality of Life and Frailty Among PLWHIV: A Cross-Sectional Study

Aims

This study aimed to explore the association between frailty and pre-frailty in people living with human immunodeficiency virus (PLWHIV), focusing on their oral health-related quality of life (OHRQoL) and health-related quality of life (HRQoL).

Materials and Methods

A cross-sectional study was conducted with 184 PLWHIV. Frailty status was assessed using Fried's frailty criteria, categorizing participants as robust, pre-frail, or frail. The oral health profile was evaluated using the World Health Organization and European Association of Public Dental Health criteria. OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14), while HRQoL was measured using the 36-Item Short-Form Health Survey version 2 (SF-36v2). Descriptive statistics were calculated, and associations were analyzed using Spearman's correlation and one-way ANOVA, with significance set at P ≤ 0.05.

Results

The pre-frail and frail PLWHIV groups reported significantly lower HRQoL scores across all domains compared to the robust group. Additionally, robust PLWHIV exhibited better oral health outcomes, with higher mean OHIP-14 scores (P = 0.005), attributed to fewer missing teeth (P = 0.019) and a higher number of filled teeth (P = 0.031). The total OHIP-14 score showed a moderate negative correlation with various SF-36v2 domains, particularly in the pre-frail and frail groups. Specifically, physical pain and physical disability subdomains of HRQoL were most affected by poorer OHRQoL.

Conclusions

Frail and pre-frail PLWHIV demonstrated significantly poorer OHRQoL compared to robust PLWHIV, with a particular impact on physical pain and physical disability. A negative correlation between OHRQoL and HRQoL was evident, especially in the frail and pre-frail groups, highlighting the interrelationship between oral health and overall well-being in this population. Clinically, this suggests that improving OHRQoL could be an essential component of healthcare for frail and pre-frail PLWHIV, as enhancing oral health may positively influence their general health outcomes. Targeted interventions to manage frailty and improve oral health are needed to enhance both OHRQoL and HRQoL in this vulnerable group.

Association between posterior occlusal support and tooth loss in a population-based cohort: The OHSAKA study

OBJECTIVES

This study aimed to assess the association between posterior occlusal support (POS) and the risk of tooth loss in older adults aged ≥75 years.

METHODS

This longitudinal study analyzed 94,422 participants who participated in multiple dental check-ups provided as part of the public healthcare services in Osaka, Japan, from 2018 to 2022. The participants were categorized into nine groups (A1-3, B1-4, and C1 and C2) according to their POS status using the Eichner index at baseline. The dental charts were compared between the initial and final assessments to assess tooth loss. Logistic regression analysis was used to examine the association between POS status and tooth loss, adjusted for several covariates, including age, sex, body mass index, periodontal status, oral hygiene, history of diabetes, history of hypertension, attendance at the annual dental check-up, and observational period. Furthermore, stratified logistic regression analyses were conducted using anterior or posterior tooth loss.

RESULTS

After controlling for confounders, POS status was associated with tooth loss. The odds ratios (ORs) with A1 as the reference were 1.74 in A2, 2.55 in A3, 3.40 in B1, 4.74 in B2, 5.79 in B3, 6.00 in B4, 4.44 in C1, and 3.00 in C2, respectively. The ORs for anterior tooth loss were higher than those for posterior tooth loss, with the highest OR observed in B4 (21.4).

CONCLUSIONS

This large population-based cohort study showed that a decreased POS was a risk indicator for tooth loss; furthermore, the risk increased even further in the anterior teeth region.

Contribution of kelp dashi liquid to sustainable maintenance of taste sensation and promotion of healthy eating in older adults throughout the umami-taste salivary reflex

Introduction

Taste decline, including taste loss in older adults, leads to malnutrition and frailty. In a super-aging society, improving taste decline and maintaining taste sensation are crucial for the wellbeing of older adults. Hyposalivation frequently affects older individuals and is the leading cause of taste decline in older adults. Treating taste decline, including taste loss, in older adults presents challenges due to the limited sustainable methods for increasing saliva production, except for drug therapy, which may lead to adverse effects. Umami-taste stimulation results in a prolonged increase in both the whole salivary flow rate (WF), more than 90% of which is secreted from the major salivary glands, and the minor salivary gland flow rate (MF) in healthy volunteers through the umami-taste salivary reflex. We hypothesized that umami-rich kelp dashi liquid (KDL), commonly used in Japanese cuisine, may alleviate taste decline and sustain normal taste sensation in older adults with hyposalivation. This study investigated whether KDL stimulation could improve taste decline.

Materials and methods

A non-randomized controlled trial was conducted at the dental department of a university hospital, involving those who presented with dry mouth between May 2017 and December 2021. Before and after repeated KDL stimulation, characteristics like changes in WF and MF, the recognition thresholds (RTs) for five basic tastes, and subjective eating and swallowing difficulties were assessed. Statistical comparisons were performed between the values measured before and after KDL stimulation.

Result

A total of 35 older patients were included. Patients with reduced MF and with or without reduced WF exhibited umami-taste loss. Repeated stimulation with KDL increased MF and WF and improved taste loss, including umami, decreased RTs, and normalized each taste. Furthermore, subjective taste impairment, subjective eating and swallowing difficulties, and burning sensations in the oral mucosa were alleviated.

Conclusion

These findings indicate that KDL stimulation improved umami-taste loss and normalized each taste sensation, further alleviating eating difficulties via the umami-taste salivary reflex. Importantly, umami-taste loss was also observed in patients with normal WF but decreased MF, who are typically not diagnosed with hyposalivation. Therefore, KDL has the potential to sustain taste sensations and promote healthy eating habits in older individuals.

Complete dentures associated with frailty among edentulous older Japanese people: A prospective analysis

OBJECTIVE

This study aimed to explore the cross-sectional and prospective associations between self-reported functionality of complete dentures (FCD), satisfaction with complete dentures (SCD) and the ability to chew hard food (ACHF) on the one hand and the frailty index (FI) on the other hand among edentulous community-dwelling older Japanese people.

METHODS

The study examined 770 edentulous participants of the Nihon University Japanese Longitudinal Study of Aging. The self-reported FCD, SCD and ability to chew six groups of food (from hardest to softest) with complete dentures were the independent variables at the baseline. The FI was computed including 40 deficits as the dependent variable at the baseline and 4 years later. Cross-sectional and prospective generalized linear regression models were fitted controlling for age, gender, marital status, education, working status and area of residence.

RESULTS

The use of non-functional complete dentures and dissatisfaction with complete dentures were both associated with a higher FI cross-sectionally (3.9% [95% CI 2.2-5.6] and 3.2% [95% CI 1.5-4.9], respectively) and prospectively (3.9% [95% CI 2.0-6.0] and 3.3% [95% CI 1.3-5.3], respectively). Regarding the ability to chew, a higher FI at baseline was observed among those able to chew food of Group 2 (1.9%, [95% CI 0.1-3.7]) and Groups 4-6 (1.9%, [95% CI 0.1-3.7]), and a progressive increment in the FI, as the participants reported being able to chew softer groups of food at the follow-up (Group 2: 2.2% [95% CI 0.05-4.3]; Group 3: 3.6% [95% CI 1.2-6.0]; and Groups 4-6: 3.4 [95% CI 0.7-6.1]).

CONCLUSION

Self-reported use of non-functional complete dentures, dissatisfaction with dentures and a reduced ACHF with complete dentures were associated with a higher FI both cross-sectionally and prospectively.

The relationship and affecting factors between oral health and frailty in the older people: A cross-sectional study

OBJECTIVE

To investigate the connection between oral health and frailty in older people and to determine the affecting factors.

DESIGN

The research was a community-based cross-sectional study.

SAMPLE

A Family Health Center conducted a study on 321 older people.

MEASUREMENTS

Data were collected face-to-face using the Personal Information Form, Geriatric Oral Health Assessment Index, and Edmonton Frailty Scale. Factors affecting oral health and frailty were examined using the MANOVA test and the relationship between them was examined using Pearson's correlation test.

RESULTS

It was determined that 52.6% of the participants had poor oral health and 56.1% had different levels of frailty. Education was effective on the Geriatric Oral Health Assessment Index scale score. The presence of chronic disease, frequency of tooth/denture brushing, age, education, and sex were effective on the Edmonton Frailty Scale. When the partial eta square values were examined, it was determined that the variable that had the highest impact on the GOHAI and EFS scale scores was educational status. It was determined that there was a significant negative relationship between participants' oral health and frailty scores (r = -0.539, p < .001).

CONCLUSIONS

It was determined that more than half of the older individuals included in the study had poor subjective oral health and varying levels of frailty. The influencing factors were determined through multivariate advanced analysis. This relationship and affecting factors are important in providing appropriate early detection and care to older people.

Nutrition Status Plays a Partial Mediation Role in the Relationship between Number of Teeth and Frailty: A Cross-Sectional Multicenter Study

INTRODUCTION

Although the relationship between the number of teeth and frailty has been extensively studied, the mediating role of nutrition status in the association between the number of teeth and frailty remains to be clarified.

METHODS

A number of 6,664 participants lived in the communities of West China were analyzed in our study. Physical frailty was determined based on the phenotype established by Fried. Nutrition status was evaluated using the Mini Nutrition Assessment-Short Form (MNA-SF) scale. Multiple linear regression was employed to evaluate the direct relationships between the number of teeth, nutrition, and frailty. Mediation models and structural equation model (SEM) pathway analysis were used to test the mediating role of nutrition status in the relationship between the number of teeth and frailty.

RESULTS

Among the 6,664 participants aged over 50 years old, the prevalence of frailty was 6.2%. Multiple linear regression analysis showed a significant total relationship between the number of teeth (β = -0.359, 95% CI: -0.473 to -0.244, p < 0.001) and frailty. After adjusting for MNA-SF scores, the relationship between the number of teeth and frailty remained significant (β = -0.327, 95% CI: -0.443 to -0.211, p < 0.001), indicating a partial mediating effect of nutrition. Mediation analysis verified that nutrition partially mediated the relationship between the number of teeth and frailty (indirect effect estimate = -0.0121, bootstrap 95% CI: -0.0151 to -0.0092; direct effect estimate = -0.0874, bootstrap 95% CI: -0.1086 to -0.0678) in the fully adjusted model. This mediating effect occurred through influencing weight loss, low level of physical activity, and debility. SEM framework pathway analysis confirmed the association between the number of teeth, nutrition, and frailty.

CONCLUSIONS

Our findings demonstrated that frailty was correlated with the number of teeth and poorer nutritional status, with nutrition partially mediating the correlation between the number of teeth and frailty. Our results supported early nutritional evaluation and intervention in oral health to decrease the risk of frailty.

Prevalence and population characteristics associated with frailty in a rural low socioeconomic area in Denmark: the Lolland-Falster Health Study

BACKGROUND

Frailty is a major geriatric syndrome that predicts increased vulnerability to minor stressor events and adverse outcomes such as falls, fractures, disability and death. The prevalence of frailty among individuals above the age of 65 varies widely with an overall weighted prevalence of 10.7%.

OBJECTIVES

The purpose of this study was to examine the prevalence of prefrailty and frailty in community-dwelling older adults from the regions of Lolland-Falster, which is one of the most socioeconomically disadvantaged areas of Denmark with lower income and lower life expectancy compared with the general Danish population. Moreover, the objective was to find selected individual characteristics associated with frailty.

DESIGN

An observational, cross-sectional registry-based population study with data from the regions of Lolland-Falster collected between February 2016 and February 2020.

RESULTS

The study included 19 000 individuals. There were 10 154 above the age of 50 included for analysis. Prevalence of frailty in the age group of 50-64 years was 4.7% and 8.7% in the age group of 65 years and above.The study demonstrates associations between frailty and high age, female gender, low education level, low income, smoking, living alone, frequency of seeing one's children and getting help when needed. These associations are comparable with findings from other studies.

CONCLUSION

The syndrome of frailty consists of not only physiological and medical issues but also education, life conditions such as living alone and living in poverty and how you evaluate your own health.

Prevalence of physical and oral frailty in geriatric patients in Kerala, India

Background

Physical frailty is a condition where a person has decreased physical reserve and resilience to stressors. Oral frailty, on the other hand, refers to a decline in oral function in conjunction with reductions in cognitive and physical functioning. Poor oral health, encompassing factors such as functional, physiological, psychosocial, and therapeutic aspects, can lead to physical frailty.

Objectives

Assess the prevalence of physical and oral frailty in geriatric patients attending health centres in Kerala, India.

Methodology

.

Design

Cross-sectional study.

Setting

Amrita Institute of Medical Sciences (Kochi), Amrita Kripa Charitable Hospital (Wayanad) and Amrita Urban Health Centre in (Kaloor).

Participants

250 geriatric participants above 60 years.

Measurements

The participants' physical frailty was evaluated using Fried's Frailty Phenotype, the Reported Edmonton Frail Scale, and sarcopenia screening. The assessment of oral frailty was based on several factors such as current dental status, chewing ability, tongue pressure, the Repetitive Saliva-Swallowing Test, Oral Diadokinetic rates, Xerostomia, and the Oral and Maxillofacial Index. The evaluation was using a questionnaire and clinical examination. Bivariate analysis was performed for additional variables, and multivariate analysis was utilized to examine the relationship between oral and physical frailty.

Results

56 % of study participants were males, and the mean age was 68 ± 6.02 years. 34.4 % were physically frail, and the remaining were pre-frail using Fried Frailty Phenotype. 67 % showed oral frailty using the Oral and Maxillofacial Frailty Index (OMFI). Using six domains of the oral frailty status (Tanaka) showed that 74 % of individuals had an increased risk of new onset of physical frailty. In the adjusted model, individuals with mild oral frailty had lesser chances of being frail (OR = 0.509, 95 % CI = 0.274-1.946, p-value = 0.033).

Conclusion

The prevalence of physical frailty was 34.4 %, and oral frailty status was 74 %. The findings implied a need to include oral frailty assessments in the comprehensive general health screening for geriatric patients.

A professional and institutional organization based on the “Aller vers” dynamic

The French Union for Oral Health (UFSBD) embodies a professional initiative in institutional form, based on the philosophy of “Aller vers” (going toward). Based on plural representation, it brings together a variety of dentists, who are representative of the diversity of practices, whether in urban or rural areas, as employees or independent practitioners, or in local practice or hospital contexts. Proximity to the public is the very essence of its action and gives it a good understanding of realities on the ground. Since its creation, the UFSBD has been engaged in an ever-evolving collective mission, adapting its efforts to the changing needs of society and citizens. Its bold approach goes beyond the traditional boundaries of dental practice, by reaching out to the most vulnerable people and those furthest from the health system. This translates into an inclusive, proactive, and local approach. This dynamic has played a decisive role in advocating, since the 1990s, the recognition of oral health as an essential component of general health. Despite the obstacles and the time required to change mentalities, the UFSBD persevered, particularly regarding the challenge that periodontal diseases represent for oral health. Challenges persist, particularly with regard to access to prevention for populations at risk, population aging, and the integration of oral health into overall care pathways. However, the main objective remains that oral health regains its place as an undeniable national priority. Indeed, the mouth is at the heart of general health and can play an essential transversal role in public health.

The Potential Value of Probiotics after Dental Implant Placement

Dental implantation is currently the optimal solution for tooth loss. However, the health and stability of dental implants have emerged as global public health concerns. Dental implant placement, healing of the surgical site, osseointegration, stability of bone tissues, and prevention of peri-implant diseases are challenges faced in achieving the long-term health and stability of implants. These have been ongoing concerns in the field of oral implantation. Probiotics, as beneficial microorganisms, play a significant role in the body by inhibiting pathogens, promoting bone tissue homeostasis, and facilitating tissue regeneration, modulating immune-inflammatory levels. This review explores the potential of probiotics in addressing post-implantation challenges. We summarize the existing research regarding the importance of probiotics in managing dental implant health and advocate for further research into their potential applications.

The Relationships of Dentition, Use of Dental Prothesis and Oral Health Problems with Frailty, Disability and Diet Quality: Results from Population-Based Studies of Older Adults from the UK and USA

OBJECTIVES

This study examined the relationships of dental status, use and types of dental prothesis and oral health problems, individually and combined, with diet quality, frailty and disability in two population-based studies of older adults.

DESIGN

Cross-sectional study.

SETTING AND PARTICIPANTS

Men form the British Regional Heart Study (BRHS) (aged 85±4 years in 2018; n=1013) and Men and Women from the Health, Aging, and Body Composition (HABC) Study (aged 75±3 years in 1998-99; n=1975).

MEASUREMENTS

Physical and dental examinations and questionnaires were collected with data available for dental status, oral problems related to eating, diet quality, Fried frailty phenotype, disability based on mobility limitations, and activities of daily living (ADL). The associations of dental status and oral health problems, individually and combined, with risk of frailty and disability were quantified. The relationship with diet quality was also assessed.

RESULTS

In the BRHS, but not HABC Study, impaired natural dentition without the use of dentures was associated with frailty independently. This relationship was only established in the same group in those with oral problems (OR=3.24; 95% CI: 1.30-8.03). In the HABC Study, functional dentition with oral health problems was associated with greater risk of frailty (OR=2.21; 95% CI: 1.18-4.15). In both studies those who wore a full or partial denture in one or more jaw who reported oral problems were more likely to have disability. There was no association with diet quality in these groups.

CONCLUSION

Older adults with impaired dentition even who use dentures who experience self-report oral problems related to eating may be at increased risk of frailty and disability. Further research is needed to establish whether improving oral problems could potentially reduce the occurrence of frailty and disability.

Number of Teeth and Denture Use Are Associated with Frailty among Chinese Older Adults: A Cohort Study Based on the CLHLS from 2008 to 2018

OBJECTIVES

The aim of this study was to determine the association between oral health and the development of frailty over a 10-year period in older Chinese adults.

DESIGN

This was a cohort study.

SETTING AND PARTICIPANTS

The data in this study were derived from the 2008, 2011, 2014 and 2018 waves of the Chinese Longitudinal Health Longevity Survey (CLHLS). The final analysis included 1155 older adults who had complete data for the Frailty Index (FI) and the other factors(oral health, sociodemographics, etc) that were analyzed in the study.

MEASUREMENTS

Frailty was assessed by the FI, which consists of 40 deficits(self-health assessments, diseases, physical functions,etc). Multivariable logistic regression was carried out to calculate the odds ratios (ORs) of the independent variables,which were obtained from investigator surveys and self-reports, in association with the development of frailty.

RESULTS

The prevalence of frailty at baseline was 22.94%, and the 10-year incidence of frailty was 24.16% (215/890). Age, number of natural teeth, use of dentures, toothache and sex were independent risk factors for frailty at baseline. After full adjustment, multivariate logistic regression analysis indicated that compared with having ≥21 teeth, edentulism (ORs 3.575; 95% CI 2.095,6.101) and partial tooth loss (ORs 2.448; 95% CI 1.592,3.766) were associated with progression to frailty. Compared with those with ≥21 teeth, those with <21 teeth and without dentures (ORs 2.617; 95% CI 1.713,3.999) were more likely to progress to frailty.

CONCLUSION

The loss of natural teeth is associated with the progression of frailty in older Chinese adults and denture using can help lower the odds of being frailty. Further research on maintain natural teeth and the appropriate use of dentures may help to establish effective frailty prevention strategies for the older adults.