The current status and influencing factors of oral frailty in elderly populations: A scoping review

Abstract

Aim: In order to serve as a reference for future studies on oral frailty interventions, this scoping review aims to provide an analysis of the factors influencing oral frailty in elderly group.

Design: A scoping review based on the principles of participants, concept and context (PCC) and a theoretical framework of the Health Ecology Model (HEM).

Review methods: Based on the principle of PCC, this study reviews the prevalence and influencing factors of oral frailty.

Data sources: A systematic search was conducted across eight Chinese and English databases with time ranged from their foundation to March 10, 2024, using a combination of subject terms and free words. For the English database Web of Science, the search formula was: #1: TI = (aged OR elder OR elderly people), #2: TI = (Oral frail* OR Oral frailty OR oral weakness), #3: #1 AND #2. And manual searches were conducted using literature tracing methods for retrospective queries.

Results: A total of 25 papers were included, reporting a prevalence of oral frailty ranging from 9.5% to 59.2%. These papers identified 34 influencing factors categorized into four levels: individual characteristics level (such as age, gender, number of teeth, number of dentures, masticatory ability, swallowing ability, oral health, tongue pressure, dry mouth, periodontitis, medications, cognitive ability, physical frailty, nutrition, type of chronic diseases, cardiovascular disease, diabetes, cancer history, hemoglobin, albumin, BMI, Cystatin C), psycho-behavioral and lifestyle level (including depression, sleep quality, dietary habits, physical activity, smoking, alcohol, and oral health-related self-efficacy), interpersonal network level (social support, social isolation), and work and living level (income status, educational level, and type of residence).

Conclusions: The high prevalence of oral frailty in the elderly group worldwide is influenced by 34 factors, highlighting the importance of considering the synergistic effects of multiple influences. Meanwhile, the OFI-6 and OFI-8 are commonly used assessment tools for oral frailty research in the elderly, and each plays an important role. OFI-8 is a self-reported and subjective assessment scale that does not require specialized oral examination tool compared to OFI-6. As a result, it is better suited for rapid screening in community and outpatient settings than the OFI-6.

Impact: Generalizing the influencing factors of oral frailty facilitates a deeper understanding of its pathogenesis, enables the identification of high-risk groups, and provides a theoretical foundation for developing interventions aimed at preventing and mitigating oral frailty among the elderly.

Patient or public contribution: Not applicable.

Keywords: Influencing factors; Oral frailty; Scoping review; The elderly.