Non-Cochrane · aetiology · PM41450504
Factors associated with oral frailty in older adults: a systematic review and meta-analysis.
Chen Yanru, Zhang Ling, Yan Wen, et al. · Frontiers in public health · 2025 · PubMed · doi:10.3389/fpubh.2025.1688322
Findings
54 findings
| Population | ||||
|---|---|---|---|---|
| Older adults (aged 60 years or more) | Age (continuous, years) | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Oral frailty assessment tool: OFI-8 score | WMD 6.69 [1.79, 11.60] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Age (continuous, years) | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Overall | WMD 4.21 [3.09, 5.33] GRADE not reported 15 studies |
| Older adults (aged 60 years or more) | Age (continuous, years) | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Oral frailty assessment tool: OFI-6 score | WMD 3.79 [2.67, 4.92] GRADE not reported 11 studies |
| Older adults (aged 60 years or more) | Age ≥80 years | Age <80 years | Oral frailty Overall | OR 4.62 [1.90, 11.21] GRADE not reported 7 studies |
| Older adults (aged 60 years or more) | Age ≥75 years | Age <75 years | Oral frailty Overall | OR 1.99 [1.55, 2.57] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Female sex | Male sex | Oral frailty Overall | OR 1.76 [1.41, 2.20] GRADE not reported 8 studies |
| Older adults (aged 60 years or more) | Female sex | Male sex | Oral frailty Oral frailty assessment tool: OFI-8 score | OR 2.34 [1.61, 3.40] GRADE not reported 4 studies |
| Older adults (aged 60 years or more) | Female sex | Male sex | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 1.30 [1.16, 1.45] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Years of education | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Overall | WMD 0.68 [-0.04, 1.41] GRADE not reported 6 studies |
| Older adults (aged 60 years or more) | Education level below junior high school | Higher education level | Oral frailty Overall | OR 1.25 [0.56, 2.78] GRADE not reported 4 studies |
| Older adults (aged 60 years or more) | Low income | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 1.43 [1.22, 1.68] GRADE not reported 4 studies |
| Older adults (aged 60 years or more) | Low income | Absence of the factor (reference group) | Oral frailty Overall | OR 1.94 [1.20, 2.68] GRADE not reported 7 studies |
| Older adults (aged 60 years or more) | Low income | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-8 score | OR 2.90 [1.39, 6.08] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Body mass index (continuous) | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Overall | WMD 1.50 [0.41, 5.59] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Body mass index (continuous) | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Oral frailty assessment tool: OFI-6 score | WMD 2.00 [1.78, 2.22] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Alcohol drinking | Absence of the factor (reference group) | Oral frailty Overall | OR 1.25 [0.58, 2.69] GRADE not reported 5 studies |
| Older adults (aged 60 years or more) | Smoking | Absence of the factor (reference group) | Oral frailty Overall | OR 1.20 [0.88, 1.63] GRADE not reported 6 studies |
| Older adults (aged 60 years or more) | Diabetes mellitus | Absence of the factor (reference group) | Oral frailty Overall | OR 1.56 [0.95, 2.57] GRADE not reported 5 studies |
| Older adults (aged 60 years or more) | Hypertension | Absence of the factor (reference group) | Oral frailty Overall | OR 1.18 [0.53, 2.60] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Sarcopenia | Absence of the factor (reference group) | Oral frailty Overall | OR 2.92 [2.54, 3.36] GRADE not reported 2 studies |
| Older adults (>=60 years) | Presence of Stroke | Absence of Stroke | Oral frailty | OR 2.68 [1.28, 5.61] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Stroke | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 2.68 [1.28, 5.61] GRADE not reported 2 studies |
| Older adults (>=60 years) | Presence of Osteoporosis | Absence of Osteoporosis | Oral frailty | OR 1.5 [1.05, 2.13] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Osteoporosis | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 1.50 [1.05, 2.13] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Malignant neoplasm | Absence of the factor (reference group) | Oral frailty Overall | OR 1.50 [0.22, 10.42] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Cognitive impairment | Absence of the factor (reference group) | Oral frailty Overall | OR 4.25 [1.72, 10.51] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Cognitive impairment | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 6.95 [4.30, 11.23] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Cognition status (MMSE score) | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Overall | WMD 1.55 [0.30, 2.81] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | ≥2 chronic conditions | <2 chronic conditions | Oral frailty Overall | OR 6.07 [2.32, 15.90] GRADE not reported 4 studies |
| Older adults (aged 60 years or more) | ≥2 chronic conditions | <2 chronic conditions | Oral frailty Oral frailty assessment tool: OFI-8 score | OR 6.07 [2.32, 15.90] GRADE not reported 4 studies |
| Older adults (aged 60 years or more) | Taking ≥5 medications | Taking <5 medications | Oral frailty Overall | OR 2.48 [1.59, 3.88] GRADE not reported 5 studies |
| Older adults (aged 60 years or more) | Taking ≥5 medications | Taking <5 medications | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 1.81 [1.46, 2.24] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Poor sleep quality | Normal sleep quality | Oral frailty Overall | OR 3.79 [1.47, 9.80] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Poor sleep quality | Normal sleep quality | Oral frailty Oral frailty assessment tool: OFI-8 score | OR 3.79 [1.47, 9.80] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Physical frailty | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-8 score | OR 7.23 [1.81, 28.87] GRADE not reported 6 studies |
| Older adults (aged 60 years or more) | Physical frailty | Absence of the factor (reference group) | Oral frailty Overall | OR 2.21 [1.63, 3.00] GRADE not reported 11 studies |
| Older adults (aged 60 years or more) | Physical frailty | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 3.63 [2.73, 4.83] GRADE not reported 4 studies |
| Older adults (aged 60 years or more) | Low physical activity level | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 1.77 [1.41, 2.22] GRADE not reported 3 studies |
| Older adults (>=60 years) | Presence of Low physical activity level | Absence of Low physical activity level | Oral frailty | OR 1.77 [1.41, 2.22] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | ADL impairment | Absence of the factor (reference group) | Oral frailty Overall | OR 4.46 [1.81, 11.01] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Depressive symptoms | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 3.76 [2.69, 5.24] GRADE not reported 4 studies |
| Older adults (>=60 years) | Presence of Depressive symptoms | Absence of Depressive symptoms | Oral frailty | OR 3.76 [2.69, 5.24] GRADE not reported 4 studies |
| Older adults (aged 60 years or more) | Depression (GDS-15 score) | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Overall | WMD 0.40 [0.16, 0.63] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Social isolation | Absence of the factor (reference group) | Oral frailty Overall | OR 1.95 [1.43, 2.65] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Malnutrition | Absence of the factor (reference group) | Oral frailty Overall | OR 2.58 [1.55, 4.28] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Malnutrition | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-8 score | OR 2.85 [1.39, 5.84] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Dietary variety score | Mean difference between oral frailty and non-oral frailty groups | Oral frailty Overall | OR 1.35 [0.56, 3.26] GRADE not reported 3 studies |
| Older adults (aged 60 years or more) | Low dietary variety | Absence of the factor (reference group) | Oral frailty Overall | OR 1.69 [1.37, 2.08] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Poor appetite | Absence of the factor (reference group) | Oral frailty Oral frailty assessment tool: OFI-6 score | OR 2.11 [1.62, 2.74] GRADE not reported 2 studies |
| Older adults (>=60 years) | Presence of Poor appetite | Absence of Poor appetite | Oral frailty | OR 2.11 [1.62, 2.74] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Eating alone | Absence of the factor (reference group) | Oral frailty Overall | OR 0.51 [0.05, 5.16] GRADE not reported 2 studies |
| Older adults (aged 60 years or more) | Not reported | None | Prevalence of oral frailty China Unresolved: the two extractors disagree on this row. | Prevalence (%) 41.2 GRADE not reported 15 studies |
| Older adults (aged 60 years or more) | Not reported | None | Prevalence of oral frailty Overall (all included studies) Unresolved: the two extractors disagree on this row. | Prevalence (%) 34.1 [29.1, 39.2] GRADE not reported 39 studies · 41854 participants |
| Older adults (aged 60 years or more) | Not reported | None | Prevalence of oral frailty Japan Unresolved: the two extractors disagree on this row. | Prevalence (%) 27.0 GRADE not reported 20 studies |
Included primary studies 39
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Lin 2022 Physical Frailty and Oral Frailty Associated with Late-Life Depression in Community-Dwelling Older Adults. PMID:35330459 | 2022 | 4 other reviews | not stated | not extracted yet |
| Komatsu 2021 Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults. PMID:33809322 | 2021 | 2 other reviews | not stated | not extracted yet |
| Iwasaki 2024 Prevalence of oral frailty and its association with dietary variety, social engagement, and physical frailty: Results from the Oral… PMID:38390632 | 2024 | 1 other review | not stated | not extracted yet |
| Nakagawa 2024 Oral frailty, appetite and dietary variety in late-stage older adults: A cross-sectional study (the STudy of lAte-stage oldeR adulTs in… PMID:38714504 | 2024 | 1 other review | not stated | not extracted yet |
| Sun 2025 Association of social frailty, sarcopenia, and oral frailty with depressive symptoms in Chinese older adults: a cross-sectional study. PMID:39910522 | 2025 | 1 other review | not stated | not extracted yet |
| Tamaki 2024 Factors correlated to oral frailty and number of remaining teeth among 80-year-old population in Japan. PMID:39614168 | 2024 | 1 other review | not stated | not extracted yet |
| Arai 2024 Association of oral frailty with medical expenditure in older Japanese adults: The study of late-stage older adults in Tottori (START… PMID:38887126 | 2025 | this review only | not stated | not extracted yet |
| Ayoob 2024 Prevalence of physical and oral frailty in geriatric patients in Kerala, India. PMID:38347898 | 2024 | this review only | not stated | not extracted yet |
| Baba 2021 Oral frailty and carriage of oral Candida in community-dwelling older adults (Check-up to discover Health with Energy for senior Residents… PMID:35098575 | 2022 | this review only | not stated | not extracted yet |
| Feng 2024 DOI:10.19568/j.cnki.23-1318.2024.05.0032 | NR | this review only | not stated | not extracted yet |
| Hiltunen 2021 Relationship between Fried's frailty phenotype and oral frailty in long-term care residents. PMID:34473831 | 2021 | this review only | not stated | not extracted yet |
| Hironaka 2020 Association between oral, social, and physical frailty in community-dwelling older adults. PMID:32480111 | 2020 | this review only | not stated | not extracted yet |
| Hoshino 2020 Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study. PMID:33575729 | 2021 | this review only | not stated | not extracted yet |
| Hu 2024 An analysis of influencing factors of oral frailty in the elderly in the community. PMID:38383363 | 2024 | this review only | not stated | not extracted yet |
| Ishii 2022 Influence of oral health on frailty in patients with type 2 diabetes aged 75 years or older. PMID:35183107 | 2022 | this review only | not stated | not extracted yet |
| Iwasaki 2020a Association between Oral Frailty and Nutritional Status among Community-Dwelling Older Adults: the Takashimadaira Study. PMID:33155629 | 2020 | this review only | not stated | not extracted yet |
| Iwasaki 2020b A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older… PMID:33396639 | 2020 | this review only | not stated | not extracted yet |
| Iwasaki 2021 Oral frailty and gait performance in community-dwelling older adults: findings from the Takashimadaira study. PMID:33612666 | 2021 | this review only | not stated | not extracted yet |
| Izutsu 2023 Risk factors for oral frailty among community-dwelling pre-frail older adults in Japan: A cross-sectional analysis. PMID:37988655 | 2023 | this review only | not stated | not extracted yet |
| Jiang 2025 DOI:10.3969/j.issn.1001-3733.2025.02.019 | NR | this review only | not stated | not extracted yet |
| Jiao 2023 DOI:10.3969/j.issn.1672-2671.2023.06.009 | NR | this review only | not stated | not extracted yet |
| Julkunen 2024 Oral frailty among dentate and edentate older adults in long-term care. PMID:38212720 | 2024 | this review only | not stated | not extracted yet |
| Kawamura 2024 Association between oral frailty and sarcopenia among frailty clinic outpatients: A cross-sectional study. PMID:38657417 | 2024 | this review only | not stated | not extracted yet |
| Kusunoki 2023 Association between oral frailty and cystatin C-related indices-A questionnaire (OFI-8) study in general internal medicine practice. PMID:37093792 | 2023 | this review only | not stated | not extracted yet |
| Luo 2025 Influencing factors of oral frailty in elderly patients with type 2 diabetes in China: a cross-sectional study based on the integral model… PMID:40217223 | 2025 | this review only | not stated | not extracted yet |
| Ma 2025 Development and validation of risk-predicting model for oral frailty in older adults patients with stroke. PMID:39972478 | 2025 | this review only | not stated | not extracted yet |
| Nishimoto 2023 Severe Periodontitis Increases the Risk of Oral Frailty: A Six-Year Follow-Up Study from Kashiwa Cohort Study. PMID:36826367 | 2023 | this review only | not stated | not extracted yet |
| Ohara 2020 Association of eating alone with oral frailty among community-dwelling older adults in Japan. PMID:32000053 | 2020 | this review only | not stated | not extracted yet |
| Park 2024 Assessment of oral hypofunction and its association with age among Korean community-dwelling older adults. PMID:38600517 | 2024 | this review only | not stated | not extracted yet |
| Tanaka 2018 Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community-Dwelling Elderly. PMID:29161342 | 2018 | this review only | not stated | not extracted yet |
| Tang 2023 DOI:10.16386/j.cjpccd.issn.1004-6194.2023.05.002 | NR | this review only | not stated | not extracted yet |
| Tu 2023 DOI:10.3761/j.issn.0254-1769.2023.11.011 | NR | this review only | not stated | not extracted yet |
| Wang 2023 DOI:10.3870/j.issn.1001-4152.2023.18.112 | NR | this review only | not stated | not extracted yet |
| Wang 2024 Current situation and influencing factors of oral frailty for community-dwelling older adults in the northeastern border areas of China: A… PMID:39260067 | 2024 | this review only | not stated | not extracted yet |
| Watanabe 2024 Oral frailty is associated with mortality independently of physical and psychological frailty among older adults. PMID:38679352 | 2024 | this review only | not stated | not extracted yet |
| Wei 2024 [Analysis of the Occurrence and Influencing Factors of Oral Frailty in Elderly Residents of Elderly Care Facilities]. PMID:39170015 | 2024 | this review only | not stated | not extracted yet |
| Yamamoto 2022 Model to Predict Oral Frailty Based on a Questionnaire: A Cross-Sectional Study. PMID:36293822 | 2022 | this review only | not stated | not extracted yet |
| Yang 2024 Physical frailty intensifies the positive association of oral frailty with poor global cognitive function and executive function among… PMID:38811863 | 2024 | this review only | not stated | not extracted yet |
| Yin2024 Epidemiology and risk factors of oral frailty among older people: an observational study from China. PMID:38515048 | 2024 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Older adults aged 60 years or older with a defined oral frailty assessment | Older adults (41,854 participants in 39 studies; 32 studies in meta-analysis) |
| Intervention | Factors (exposures) associated with oral frailty | 27 factors in meta-analysis (sociodemographic, comorbidity, physical function, social and psychological, dietary) |
| Comparison | Older adults without the factor | Absence of the factor or continuous level |
| Outcomes | Oral frailty | Oral frailty (OFI-5, OFI-6, OFI-8 and other tools) |
| Study designs | Case-control, cohort and cross-sectional studies | 35 cross-sectional, 3 cohort, 1 longitudinal study |
| Timing | Not specified | Not specified |