Oral health status and its relation to frailty in older adults: a cross-sectional study

Given the growing burden of population aging and the emerging evidence linking oral health to functional decline, further investigation in diverse settings is warranted. In this study, we aimed to investigate the association between oral health status and frailty among older adults in Indonesia. A cross-sectional study was conducted among 405 community-dwelling older adults aged 60 years and older residing in five sub-districts in Sleman, Yogyakarta, Indonesia, using a multistage cluster random sampling method. Frailty was assessed using the frailty phenotypic criteria and categorized as frail (≥ 3), pre-frail (1–2), or robust (none). Oral health parameters, including the number of functional tooth units (FTUs), dental caries, dysphagia (15-item scale), xerostomia (five-item Summated Xerostomia Inventory-Indonesian version), and oral health-related behaviors, were examined as independent variables. Multinomial and binary logistic regression analyses were conducted with frailty as the outcome variable, adjusting for sociodemographic characteristics, nutritional status, smoking behavior, chronic diseases, and number of medications. Among the 405 participants, 16% were classified as frail and 75% as pre-frail. After adjusting for potential confounders, a greater number of FTUs were associated with lower odds of being frail and pre-frail. In contrast, a lower number of functional tooth units was associated with higher odds of exhaustion and weakness. Dysphagia was associated with higher levels of exhaustion, and xerostomia showed a similar pattern. Poorer oral health, particularly a lower number of functional tooth units, was associated with greater frailty among older adults. Dysphagia and xerostomia were associated with exhaustion. These findings highlight the relevance of maintaining oral function to promote healthy aging.