Current situation and influencing factors of oral frailty among community-dwelling older adults with chronic diseases in China: a cross-sectional study

Abstract

Objective To examine the prevalence and associated factors of oral frailty among community-dwelling older adults with chronic diseases in minority communities in Northeast China. Methods A cross-sectional study was conducted from November to December 2023 using convenience sampling in three communities in Yanji City, Yanbian Korean Autonomous Prefecture. Participants aged 60 years and older with at least one diagnosed chronic disease and a minimum of four natural teeth completed the Mandarin Chinese versions of the Oral Frailty Index-8 (OFI-8), the FRAIL scale, the Pittsburgh Sleep Quality Index (PSQI), and the Attitudes to Aging Questionnaire (AAQ). Binary logistic regression was used to identify factors independently associated with oral frailty. Results Among 393 valid participants, oral frailty was identified in 280 individuals, yielding a prevalence of 71.2% (OFI-8 score: 5.61 ± 2.58). The most frequently reported OFI-8 items were difficulty eating hard food (62.3%), choking (48.6%), and dry mouth (45.8%). After adjustment, advanced age, female sex, low personal monthly income, both low and high BMI, alcohol consumption, physical frailty, sleep disturbance, a negative attitude toward aging, having three or more chronic diseases, and diabetes mellitus were independently associated with oral frailty (all p < 0.05). Conclusion Oral frailty is highly prevalent among older adults with chronic diseases in minority communities of Northeast China and is independently associated with multimorbidity, particularly diabetes. Screening for oral frailty should be integrated into routine community-based chronic disease management, with targeted prevention efforts focusing on modifiable behavioral and psychosocial determinants.