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.
Rachel Kimble, A Olia Papacosta, Lucy T Lennon and 5 others
PMID 36584971WHAT IT FOUND
Older adults with fewer natural teeth, no teeth, or dry mouth were more likely to progress to physical frailty over 8 years.
Links to severe frailty were weaker and often disappeared after adjustment.
Key findings
01In the UK cohort, after full adjustment, men with no natural teeth had an odds ratio of 2.26 for progressing to frailty, and men with fewer than 21 natural teeth had an odds ratio of 1.79.
02Dry mouth was associated with frailty progression in both cohorts; in the US cohort the adjusted odds ratio was 2.62.
03For severe frailty, only the US cohort retained adjusted associations for no natural teeth (odds ratio 4.44) and fewer than 21 teeth without dentures (odds ratio 3.37); in the UK cohort no adjusted associations remained.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
This was an observational cohort, not a dental or medical treatment trial, so it cannot show that poor oral health causes frailty or that treating oral health prevents frailty. The authors could not exclude residual confounding; shared age-related conditions, medications, diet, inflammation, or other factors may explain the associations. Generalisability is limited: the UK cohort was white men, and the US cohort came from only two US areas, so results may not apply to all older adults. Frailty measures did not include cognitive decline or psychosocial aspects, so the frailty picture is incomplete. Difficulty eating was not graded by severity, and denture type and quality were not examined, so eating-related mechanisms are uncertain. Periodontal disease associations were not observed and may have been underpowered because the analysis was limited to people with teeth.
Declared interests
No author conflicts of interest were declared. The article metadata lists NIH and non-U.S. government research support.
The easy way to misread this
Do not conclude that improving oral health or giving dentures will prevent frailty. This was an observational cohort study of associations over time, not a treatment trial, and it cannot separate oral health from medications, nutrition, comorbidity, or inflammation.