Oral Frailty is a Predictor for Poorer Cognitive Performance in Community-dwelling Older Adults

Introduction: 

Oral frailty has been associated with cognitive decline and impairment in older adults. Physical performance is another well-established correlate of cognitive function alongside demographic and psychosocial factors. However, it remains unclear whether oral frailty provides information beyond these established measures. We therefore examined whether oral frailty contributed additional explanatory value to cognitive performance, beyond demographic, psychosocial and physical-performance factors, in community-dwelling older adults. 

Methods: 

A cross-sectional analysis was conducted using data from community-dwelling older adults participating in health screening programmes in an urban town (n=184). Participants with complete data were included (n = 184). Oral frailty was assessed using the Oral Frailty-5 questionnaire and cognitive function using the Abbreviated Mental Test. Hierarchical multivariable linear regression was performed. A base model included demographic (age, sex, education and housing), psychosocial (depressive symptoms, loneliness and sleep quality) and physical-performance variables (SPPB [Short Physical Performance Battery], TUG (Timed Up and Go) score, FRAIL scale and grip strength). Oral frailty was subsequently added to the model to determine its incremental explanatory value for cognitive performance. 

Results: 

Participants had a mean age of 63.6 ± 7.3 years (89.7% female, 92.9% Chinese). Higher oral frailty scores were independently associated with poorer cognitive performance after adjustment for demographic, psychosocial and physical-performance factors (β = -0.225, p = 0.006). Oral frailty scores significantly improved model fit when added to this base model, increasing explained variance from 17.3% to 21.1% (ΔR² = 0.038, F = 7.82). 

Conclusion: 

Oral frailty was independently associated with poorer cognitive performance in community-dwelling older adults providing explanatory value beyond established demographic, socioeconomic, psychosocial and physical-performance factors. These findings suggest oral health may serve as a useful additional marker of cognitive risk in community-based screening.