Background: The risk of malnutrition is common among older adults and is influenced by factors such as frailty, oral health, and dietary well-being. This study examined the association of frailty, masticatory performance, and dietary well-being with malnutrition risk in rural community-dwelling older adults.
Methods: A cross-sectional observational study used a convenience sample of 269 adults over 65 from community sites in southern Taiwan. Data were collected through self-reported questionnaires, the Mini Nutritional Assessment (MNA)-Short Form, the Dietary Well-being Scale, frailty measured by the Study of Osteoporotic Fractures (SOF) frailty index, the Iowa Oral Performance Instrument, and a chewing gum test. Logistic regression and stratified analyses were used to examine associations between predictors and malnutrition risk.
Results: Frailty was significantly associated with increased malnutrition risk (OR = 2.47, p = 0.008), while greater masticatory performance was associated with reduced risk (OR = 0.67, p = 0.006). Stratified analyses showed that frailty was linked to higher malnutrition risk among individuals with chronic diseases, fewer than 20 teeth, or denture use. Masticatory performance was inversely associated with malnutrition risk, particularly in those with tooth loss and dentures. Dietary well-being had a protective effect in participants with chronic diseases (OR = 0.97, p = 0.040).
Conclusions: Frailty and poor masticatory performance are associated with an increased risk of malnutrition in older adults. Integrating oral health, chronic disease management, and dietary support is essential for prevention, especially in rural communities.
Keywords: Community-dwelling older adults; Dietary well-being; Frailty; Oral health; Risk of malnutrition.
Copyright © 2026. Published by Elsevier Inc.