Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec;14(6):1307-1315.
doi: 10.1007/s41999-023-00859-x. Epub 2023 Sep 20.

Relationship between oral frailty, health-related quality of life, and survival among long-term care residents

Taija Puranen  1   2 , Kaija Hiltunen  3 , Hannu Kautiainen  4   5 , Merja H Suominen  6 , Karoliina Salminen  6 , Päivi Mäntylä  7   8 , Hanna-Maria Roitto  9   10   11 , Kaisu H Pitkälä  6   12 , Riitta K T Saarela  13
Affiliations

Relationship between oral frailty, health-related quality of life, and survival among long-term care residents

Taija Puranen et al. Eur Geriatr Med. 2023 Dec.

Erratum in

Abstract

Purpose: We evaluated oral frailty (OFr) and its association with health-related quality of life (HRQoL), energy and protein intake, and survival among older long-term care residents.

Methods: This cross-sectional study with a 3-year follow-up for survival assessed 349 residents in long-term care facilities (73% female, mean age 82 years). We defined OFr with six signs (dry mouth, food residue on oral surfaces, unclear speech, inability to keep mouth open or pain expression during the clinical oral examination, diet pureed/soft) and OFr severity was categorized as Group 1, (mild) = 0-1 signs, Group 2 (moderate) = 2-4 signs, and Group 3 (severe) = 5-6 signs. We measured HRQoL with 15D instrument, and energy and protein intake by a 1- to 2-day food record. Mortality was retrieved from central registers on March 2021.

Results: Of the residents, 15% had 0-1, 67% 2-4 and 18% 5-6 OFr signs. HRQoL decreased linearly from Group 1 to Group 3. OFr correlated with such dimensions of HRQoL as mobility, eating, speech, excretion, usual activities, mental function, and vitality. We found no association between OFr categories and energy and protein intake. Survival decreased linearly from Group 1 to Group 3.

Conclusions: OFr was common among older long-term care residents and OFr severity predicts poorer outcomes. The six oral signs denoting OFr may be used at the bedside to screen residents at risk for OFr.

Keywords: Health-related quality of life; Long-term care; Nutrient intake; Oral frailty; Survival.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
The flow chart of the study
Fig. 2
Fig. 2
Spearman’s correlations with 95% confidence intervals between number of oral frailty signs and dimensions of health-related quality of life (HRQoL) measured by 15D
Fig. 3
Fig. 3
Kaplan–Meier survival curves of residents in long-term care facilities according to OFr categories (Group 1 = 0–1 signs, Group 2 = 2–4 signs, and Group 3 = 5–6 signs) adjusted for sex, age, and Charlson comorbidity index. Adjusted survival (%) decreased when the number of OFr signs increased
See this image and copyright information in PMC

Comment in

References

    1. Porter J, Ntouva A, Read A, Murdoch M, Ola D, Tsakos G. The impact of oral health on the quality of life of nursing home residents. Health Qual Life Outcomes. 2015;13:102. doi: 10.1186/s12955-015-0300-y. - DOI - PMC - PubMed
    1. Kotronia E, Brown H, Papacosta O, Lennon LT, Weyant RJ, Whincup PH, Wannamethee SG, Ramsay SE. Oral health problems and risk of incident disability in two studies of older adults in the United Kingdom and the United States. J Am Geriatr Soc. 2022;70:2080–2092. doi: 10.1111/jgs.17792. - DOI - PMC - PubMed
    1. Azzolino D, Passarelli PC, De Angelis P, Piccirillo GB, D'Addona A, Cesari M. Poor oral health as a determinant of malnutrition and sarcopenia. Nutrients. 2019;11:2898. doi: 10.3390/nu11122898. - DOI - PMC - PubMed
    1. Tanaka T, Takahashi K, Hirano H, Kikutani T, Watanabe Y, Ohara Y, Furuya H, Tetsuo T, Akishita M, Iijima K. Oral frailty as a risk factor for physical frailty and mortality in community-dwelling elderly. J Gerontol A Biol Sci Med Sci. 2018;73:1661–1667. doi: 10.1093/gerona/glx225. - DOI - PubMed
    1. Matsuo K, Kito N, Ogawa K, Izumi A, Masuda Y. Effects of textured foods on masticatory muscle activity in older adults with oral hypofunction. J Oral Rehabil. 2020;47:180–186. doi: 10.1111/joor.12901. - DOI - PubMed

Publication types