EXPLORING ASSOCIATIONS BETWEEN FRAILTY AND ORAL HEALTH IN COMMUNITY-DWELLING OLDER PEOPLE

Abstract This study explores associations between frailty and oral health in cross-sectional data of 1,202 community-dwelling older people. Two dichotomous outcomes were used: 1. Potential frailty, using routine primary care data; 2. Self-reported frailty, using a questionnaire. Oral health concerned dental record data and self-reported oral problems. Following exploration of univariate associations, age and sex adjusted multivariate logistic regressions were performed. For potential frailty and self-reported frailty associations were found with dental emergency visit (odds ratio (OR)= 2.0, 95% confidence Interval (CI)=1.33;3.02 respectively OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (resp. OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07), making dietary adjustments (resp. OR=2.66, 95% CI= 1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01). Additional associations were found for self-reported frailty with wearing dental prosthesis (OR=3.33, 95% CI=1.49;7.44) and missing periodontal information (OR=1.56, 95% CI=1.05;2.32). The cross-sectional data of this study show that in community dwelling older people oral health is associated with frailty.

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Exploring associations between oral health and frailty in community-dwelling older people

Journal of Frailty & Aging ◽

10.14283/jfa.2020.55 ◽

2020 ◽

pp. 1-7

Author(s):

B. Everaars ◽

K. Jerković – Ćosić ◽

N. Bleijenberg ◽

N.J. de Wit ◽

G.J.M.G. van der Heijden

Keyword(s):

At Risk ◽

Oral Health ◽

Older People ◽

Dental Care ◽

Community Dwelling ◽

Care Utilization ◽

Emergency Visit ◽

Dental Care Utilization ◽

Community Dwelling Older People ◽

Dental Emergency

Background: In frail older people with natural teeth factors like polypharmacy, reduced salivary flow, a decrease of oral self-care, general healthcare issues, and a decrease in dental care utilization contribute to an increased risk for oral complications. On the other hand, oral morbidity may have a negative impact on frailty. Objective: This study explored associations between oral health and two frailty measures in community-dwelling older people. Design: A cross-sectional study. Setting: The study was carried out in a Primary Healthcare Center (PHC) in The Netherlands. Participants: Of the 5,816 persons registered in the PHC, 1,814 persons were eligible for participation at the start of the study. Measurements: Two frailty measures were used: 1. Being at risk for frailty, using Electronical Medical Record (EMR) data, and: 2. Survey-based frailty using ‘The Groningen Frailty Indicator’ (GFI). For oral health measures, dental-record data (dental care utilization, dental status, and oral health information) and self-reported oral problems were recorded. Univariate regression analyses were applied to determine the association between oral health and frailty, followed by age- and sex-adjusted multivariate logistic regressions. Results: In total 1,202 community-dwelling older people were included in the study, 45% were male and the mean age was 73 years (SD=8). Of all participants, 53% was at risk for frailty (638/1,202), and 19% was frail based on the GFI (222/1,202). A dental emergency visit (Odds Ratio (OR)= 2.0, 95% Confidence Interval (CI)=1.33;3.02 and OR=1.58, 95% CI=1.00;2.49), experiencing oral problems (OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07;3.99), and making dietary adaptations (OR=2.66, 95% CI=1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01) were associated with being at risk for frailty and survey-based frailty respectively. Conclusions: A dental emergency visit and self-reported oral health problems are associated with frailty irrespective of the approach to its measurement. Healthcare professionals should be aware of the associations of oral health and frailty in daily practice.

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Letter to the Editor: Exploring Associations Between Oral Health and Frailty in Community-Dwelling Older People

Journal of Frailty & Aging ◽

10.14283/jfa.2021.10 ◽

2021 ◽

pp. 1-1

Author(s):

R.C. Castrejón-Pérez

Keyword(s):

Oral Health ◽

Older People ◽

Medical Record ◽

Frailty Index ◽

Community Dwelling ◽

Frailty Phenotype ◽

Cross Sectional ◽

Frailty Status ◽

Community Dwelling Older People ◽

Oral Conditions

The studies exploring the association between oral conditions and Frailty status are increasing in number, and many manuscripts have been published during the last couple of years. Even when Everaars et al. (1) manuscript is cross-sectional, it contributes to the knowledge by confirming the association between oral conditions and Frailty despite the selected strategy for measuring Frailty since authors added the interview Groningen Frailty Index and the Frailty Index (computed with data extracted from the Electronic Medical Record) to the most frequently used Frailty Phenotype and Kihon checklist (2).

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Drug Burden Index associated with function in community-dwelling older people in Finland: A cross-sectional study

Annals of Medicine ◽

10.3109/07853890.2011.573499 ◽

2011 ◽

Vol 44 (5) ◽

pp. 458-467 ◽

Cited By ~ 35

Author(s):

Danijela Gnjidic ◽

J. Simon Bell ◽

Sarah N. Hilmer ◽

Eija Lönnroos ◽

Raimo Sulkava ◽

...

Keyword(s):

Older People ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Drug Burden Index ◽

Community Dwelling Older People

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The cross‐sectional association between diabetes and orthostatic hypotension in community‐dwelling older people

Diabetic Medicine ◽

10.1111/dme.14187 ◽

2019 ◽

Vol 37 (8) ◽

pp. 1299-1307 ◽

Cited By ~ 1

Author(s):

J. Gannon ◽

P. Claffey ◽

E. Laird ◽

L. Newman ◽

R.A. Kenny ◽

...

Keyword(s):

Older People ◽

Orthostatic Hypotension ◽

Community Dwelling ◽

Cross Sectional ◽

Community Dwelling Older People ◽

The Cross

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Nutritional Status and Risk Factors for Frailty in Community-Dwelling Older People: A Cross-Sectional Study

Nutrients ◽

10.3390/nu12041041 ◽

2020 ◽

Vol 12 (4) ◽

pp. 1041 ◽

Cited By ~ 2

Author(s):

Pilar Pérez-Ros ◽

Rafael Vila-Candel ◽

Lourdes López-Hernández ◽

Francisco Miguel Martínez-Arnau

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Nutritional Status ◽

Older People ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sectional Study ◽

Cross Sectional ◽

Community Dwelling Older People ◽

The Relationship

Objective: This study aims to assess the relationship that frailty has with nutritional status and functional risk factors in community-dwelling older adults. Methods: Cross-sectional study in community-dwelling older people, independent for walking and without impaired cognition. Frailty was assessed by Fried criteria. Nutritional status was analyzed by the Mini Nutritional Assessment Short Form (MNA-SF), biochemical markers (albumin, total proteins, cholesterol, lymphocytes, and hemoglobin); and anthropometric parameters (body mass index [BMI], body fat percentage, handgrip, and perimeters). A comprehensive geriatric assessment analyzed other risk factors: functionality, cognition, falls, comorbidity, polypharmacy, physical activity, and quality of life (QoL). Results: We included 564 elderly people with a mean age of 76.05 (standard deviation 3.97) years; 63.1% (n = 356) were women, and 83.9% (n = 473) were prefrail, and frail. The sample presented high functionality and a nutritional status with a predominance of overweight and obesity. Factors associated with frailty (R2 = 0.43) were age over 75 years (odds ratio [OR] 3.31, 95% confidence interval [CI] 1.76, 6.21; p < 0.001), female gender (OR 2.37, 95% CI 1.24, 4.52; p = 0.009), anemia (OR 2.45, 95% CI 1.19, 5.02; p = 0.015), falls (OR 1.94, 95% CI 1.12, 3.25; p = 0.016) and the fear of falling (OR 4.01: 95% CI 1.76, 9.16; p = 0.001). Performing more than 3 weekly hours of physical activity was found to be a protective factor (OR 0.23, 95% CI 0.15, 0.35; p < 0.001). Conclusions: The relationship between frailty and malnutrition in functionally independent community-dwelling older people is unclear. More studies are needed to know what nutritional markers are related to frailty, cognition, and functionality in order to discriminate the risk factors for community-dwelling older people at risk of malnutrition and dependency.

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Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-032904 ◽

2019 ◽

Vol 9 (10) ◽

pp. e032904 ◽

Cited By ~ 3

Author(s):

Kirubakaran Kesavan Kendhapedi ◽

Niveditha Devasenapathy

Keyword(s):

Older People ◽

Fear Of Falling ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Cross Sectional ◽

Domain Definition ◽

Tilburg Frailty Indicator ◽

Community Dwelling Older People ◽

Frailty Indicator

ObjectiveThere is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated with frailty. We further explored the associations between frailty with fear of falling and falls.DesignCommunity based cross-sectional study.SettingFour villages in Thanjavur district of Southern India.ParticipantsRandom sample of adults aged 60 years and above from four villages.MethodsWe sampled community-dwelling older adults from the electoral list of four villages using stratified random sampling. We report prevalence of frailty as defined by physical definition (Fried’s Phenotype), accumulation of deficits (Frailty Index) and multi-domain definition (Tilburg Frailty Indicator). We report proportion of agreement of frailty status between the frailty tools. We used logistic regressions with robust SEs to examine the associations between socio-demographic determinants with frailty and the association between frailty with fear of falling and falls.ResultsAmong the 408 participants, the weighted (non-response and poststratification for sex) prevalence and 95% CI of frailty was 28% (18.9 to 28.1) for physical definition, 59% (53.9 to 64.3) for accumulation of deficits and 63% (57.4 to 67.6) for multi-domain definition. Frailty Index and Tilburg Frailty Indicator had good agreement (80%). Age, female, lower education, lower socioeconomic status, minimum physical activity in routine work were independently associated with frailty irrespective of the frailty definitions. Frail elderly had higher odds of falls as well as fear of falling compared with non-frail, irrespective of the definitions.ConclusionPrevalence of frailty among older people in rural Thanjavur district of South India was high compared with low-income and middle-income countries. Understanding the modifiable determinants of frailty can provide a valuable reference for future prevention and intervention.

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Relationship between Perceived Indoor Temperature and Self-Reported Risk for Frailty among Community-Dwelling Older People

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040613 ◽

2019 ◽

Vol 16 (4) ◽

pp. 613 ◽

Cited By ~ 3

Author(s):

Yukie Nakajima ◽

Steven Schmidt ◽

Agneta Malmgren Fänge ◽

Mari Ono ◽

Toshiharu Ikaga

Keyword(s):

Older People ◽

Economic Status ◽

Frailty Index ◽

Cross Sectional Study ◽

Community Dwelling ◽

Indoor Temperature ◽

Cross Sectional ◽

Economic Satisfaction ◽

Increased Risk ◽

Community Dwelling Older People

This study investigated the relationship between perceived indoor temperature in winter and frailty among community-dwelling older people. This cross-sectional study included 342 people 65 years and older in Japan. Participants answered questions about demographics, frailty, housing, and perceived indoor temperature in winter. Participants were grouped based on perceived indoor temperature (Cold or Warm) and economic satisfaction (Unsatisfied or Satisfied). Differences in the frailty index between perceived indoor temperature groups and economic satisfaction groups were tested by using ANCOVA and MANCOVA. An interaction effect showed that people in the Cold Group and unsatisfied with their economic status had significantly higher frailty index scores (F(1, 336) = 5.95, p = 0.015). Furthermore, the frailty index subscale of fall risk was the specific indicator of frailty that accounted for this significant relationship. While previous research has shown the risks related to cold indoor temperature in homes, interestingly among those who reported cold homes, only those who were not satisfied with their economic situation reported being at increased risk for frailty. This highlights the potential importance of preventing fuel poverty to prevent frailty.

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