Effects and evaluation of oral frailty ın geriatric individuals: A Review

Abstract

Oral frailty is a concept that describes the deterioration in oral functions frequently seen in geriatric individuals. Some physical (physical frailty, osteoporosis, sarcopenia, muscle strength, physical functions) and psychosocial factors (depression, social isolation, cognitive functions) are closely related to oral frailty. Since oral frailty also leads to malnutrition, individuals become prone to systemic diseases and infections. Clinical indicators of oral frailty include the number of teeth remaining in the mouth, chewing and swallowing difficulties, dry mouth, articulatory oral motor skills, pain in the oral region, oral hygiene skills and oral health behaviors. Tools such as Oral Frailty Index-8, 5-item Oral Frailty Checklist and Oral Frailty Assessment Tool can be used in the assessment of oral frailty. Due to systemic risk factors, the assessment of oral frailty in routine oral and dental health screenings is of great importance in geriatric individuals.

Keywords

• Frailty
• Oral Health
• Frail Elderly
• Geriatric Assessment
• Geriatric Dentistry

Geriatrik bireylerde oral kırılganlığın etkileri ve değerlendirilmesi :Derleme

Abstract

Oral kırılganlık geriatrik bireylerde sıklıkla görülen ağız fonksiyonlarındaki bozulmayı anlatan bir kavramdır. Bazı fiziksel (fiziksel kırılganlık, osteoporoz, sarkopeni, kas kuvveti, fiziksel fonksiyonlar) ve psikososyal etmenler (depresyon, sosyal izolasyon, bilişsel fonksiyonlar) oral kırılganlık ile yakından ilişkilidir. Oral kırılganlık yetersiz beslenmeye de yol açtığı için, bireyler sistemik hastalık ve enfeksiyonlara yatkın hale gelir. Oral kırılganlığın klinik göstergeleri arasında, ağızda kalan diş sayısı, çiğneme ve yutma zorlukları, ağız kuruluğu, artiküler oral motor beceriler, oral bölgede ağrı, oral hijyen becerileri ve ağız sağlığı davranışları bulunmaktadır. Oral kırılganlık değerlendirmesinde Oral Kırılganlık İndeksi-8, 5 maddelik Oral Kırılganlık Kontrol Listesi ve Oral Kırılganlık Değerlendirme Aracı gibi araçlar kullanılabilir. Sistemik risk faktörleri sebebi ile, geriatrik bireylerde rutin ağız, diş sağlığı taramalarında oral kırılganlığın değerlendirilmesi büyük önem taşır.

Keywords

• Kırılganlık
• Ağız Sağlığı
• Kırılgan Yaşlılar
• Geriatrik Değerlendirme
• Geriatrik Diş Hekimliği

References

1. 1.Tanaka T, Hirano H, Ikebe K, et al. Consensus statement on "Oral frailty" from the Japan Geriatrics Society, the Japanese Society of Gerodontology, and the Japanese Association on Sarcopenia and Frailty. Geriatr Gerontol Int 2024;24(11):1111–9.
2. 2.Tanaka T, Takahashi K, Hirano H, et al. Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly. J Gerontol A Biol Sci Med Sci 2018;73(12):1661–7.
3. 3.Yang C, Gao Y, An R, et al. Oral frailty: a concept analysis. J Adv Nurs 2024;80(8):3134–45.
4. 4.Huang P, Wu L, Zhang R, et al. Systematic review and meta-analysis on the prevalence and risk factors of oral frailty among older adults. Front Med (Lausanne) 2025;12:1512927.
5. 5.Tanaka T, Hirano H, Ikebe K, et al. Oral frailty five-item checklist to predict adverse health outcomes in community-dwelling older adults: a Kashiwa cohort study. Geriatr Gerontol Int 2023;23(9):651–9.
6. 6. Kusunoki H, Hasegawa Y, Nagasawa Y, et al. Oral Frailty and Its Relationship with Physical Frailty in Older Adults: A Longitudinal Study Using the Oral Frailty Five-Item Checklist. Nutrients. 2024;17(1):17. Published 2024 Dec 24. doi:10.3390/nu17010017
7. 7.Hu S, Li X. An analysis of influencing factors of oral frailty in the elderly in the community. BMC Oral Health 2024;24(1):260.
8. 8.Dibello V, Lozupone M, Manfredini D, et al. Oral frailty and neurodegeneration in Alzheimer's disease. Neural Regen Res 2021;16(11):2149–53.

9. 9.Sire A de, Ferrillo M, Lippi L, et al. Sarcopenic dysphagia, malnutrition, and oral frailty in elderly: a comprehensive review. Nutrients 2022;14(5):982.
10. 10.Zhao H, Wu B, Zhou Y, et al. Oral frailty: a concept analysis. BMC Oral Health 2024;24(1):594.
11. 11.Tamaki N, Hiroshimaya T, Fukuhara K, et al. Factors correlated to oral frailty and number of remaining teeth among 80-year-old population in Japan. BMC Geriatr 2024;24(1):979.
12. 12.Kamide N, Ando M, Murakami T, et al. The association of oral frailty with fall risk in community-dwelling older adults: a cross-sectional, observational study. Eur Geriatr Med 2024;15(1):279–83.
13. 13.Kojima G. Frailty as a predictor of future falls among community-dwelling older people: a systematic review and meta-analysis. J Am Med Dir Assoc 2015;16(12):1027–33.
14. 14.Yokoyama H, Kitano Y. Oral frailty as a risk factor for fall incidents among community-dwelling people. Geriatrics (Basel) 2024;9(2):54.
15. 15.Beaudart C, Zaaria M, Pasleau F, et al. Health outcomes of sarcopenia: a systematic review and meta-analysis. PLoS One 2017;12(1):e0169548.
16. 16.Dibello V, Lobbezoo F, Lozupone M, et al. Oral frailty indicators to target major adverse health-related outcomes in older age: a systematic review. Geroscience 2023;45(2):663–706.
17. 17.Hakeem FF, Bernabé E, Sabbah W. Association between oral health and frailty: A systematic review of longitudinal studies. Gerodontology 2019;36(3):205–15.
18. 18.Iwasaki M, Watanabe Y, Motokawa K, et al. Oral frailty and gait performance in community-dwelling older adults: findings from the Takashimadaira study. J Prosthodont Res 2021;65(4):467–73.
19. 19.Zhu S-R, Feng X-J, Zheng W-K, et al. Unfavourable outcomes in older adults with oral frailty: a scoping review. Clin Interv Aging 2024;19:1979–95.
20. 20.Tanaka T, Hirano H, Ohara Y, et al. Oral frailty index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults. Arch Gerontol Geriatr 2021;94:104340.
21. 21.Jiang Z, Liu X, Lü Y. Unhealthy oral status contributes to the older patients with cognitive frailty: an analysis based on a 5-year database. BMC Geriatr 2022;22(1):980.
22. 22.Ma KS, Hasturk H, Carreras I, et al. Dementia and the risk of periodontitis: a population-based cohort study. J Dent Res 2022;101(3):270–7.
23. 23.Chen Y-C, Ku E-N, Lin C-W, et al. Tongue pressure during swallowing is an independent risk factor for aspiration pneumonia in middle-aged and older hospitalized patients: An observational study. Geriatr Gerontol Int 2024;24 Suppl 1:351–7.
24. 24.Dibello V, Lobbezoo F, Panza F, et al. Oral frailty indicators and cardio- and cerebrovascular diseases in older age: A systematic review. Mech Ageing Dev 2025;223:112010.
25. 25.Zhu S-R, Wei L-Y, Jia K, et al. Prevalence and unfavourable outcome of oral frailty in older adult: a systematic review and meta-analysis. Front Public Health 2024;12:1501793.
26. 26.Irie K, Mochida Y, Altanbagana NU, et al. Relationship between risk of oral frailty and awareness of oral frailty among community-dwelling adults: a cross-sectional study. Sci Rep 2024;14(1):433.
27. 27.Castrejón-Pérez RC, Borges-Yáñez SA. Frailty from an oral health point of view. J Frailty Aging 2014;3(3):180–6.
28. 28.Mihara Y, Matsuda K-I, Ikebe K, et al. Association of handgrip strength with various oral functions in 82- to 84-year-old community-dwelling Japanese. Gerodontology 2018;35(3):214–20.
29. 29.El-Solh AA, Pietrantoni C, Bhat A, et al. Microbiology of severe aspiration pneumonia in institutionalized elderly. Am J Respir Crit Care Med 2003;167(12):1650–4.
30. 30.Kimura C, Miura K, Watanabe Y, et al. Association between oral frailty and Prevotella percentage in the oral microbiota of community-dwelling older adults who participated in the CHEER Iwamizawa project, Japan. J Oral Rehabil 2024;51(9):1721–9.
31. 31.Nishimoto M, Tanaka T, Hirano H, et al. Severe periodontitis increases the risk of oral frailty: a six-year follow-up study from Kashiwa cohort study. Geriatrics (Basel) 2023;8(1):25.
32. 32.Castrejón-Pérez RC, Wanyonyi KL, García-Vázquez PE, et al. Frailty index and ten oral conditions in the coyoacan cohort study: A cross-sectional analysis. Gerodontology 2023;40(3):372–81.
33. 33.Dibello V, Zupo R, Sardone R, et al. Oral frailty and its determinants in older age: a systematic review. Lancet Healthy Longev 2021;2(8):e507-e520.
34. 34.Ko C-H, Chao C-L, Hung C-H, et al. Nutritional status, frailty, oral health, and oral motor functions in long-term care residents with swallowing dysfunction. J Clin Med 2024;14(1):62.
35. 35.Wan Q, Yang Y, Yang C. Oral frailty assessment tool: instrument development and cross-sectional validation study. Innov Aging. 2024;8:1262.
36. 36.Kang J-H, Park S-C, Jung H-I, et al. Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults. Epidemiol Health 2023;46:e2024008.
37. 37.Watanabe Y, Matsuda N, Miura K, et al. Oral frailty and its association with systemic health: A narrative review. Oral Sci Int 2025;22(1):e1278.