Oral frailty in older adults: a scoping review of risk factors, adverse outcomes, and interventions

Oral frailty (OF) is a significant geriatric syndrome, characterized by cumulative declines in oral function, with broad health implications. This scoping review synthesizes the existing evidence on the risk factors, adverse outcomes, and interventions related to OF in older adults. Following the PRISMA-ScR framework, we systematically searched PubMed, Embase, CINAHL, Web of Science, PsycINFO, and the Cochrane Library from inception to January 9, 2025. Two independent researchers conducted literature screening and data extraction, focusing on the first author, title, publication year, country, population, study design, sample size, scales, risk factors, adverse outcomes, and interventions. A total of 589 records were identified, of which 64 studies met the inclusion criteria: 47 cross-sectional studies, 15 longitudinal studies, and 2 experimental studies. The analysis revealed OF risk factors across six domains: sociodemographic, physical/disease-related, oral health-related, dietary/nutritional, psychosocial, and lifestyle factors, with oral health-related factors being the most frequently reported. Adverse outcomes associated with OF included multidimensional health declines such as physical frailty/sarcopenia, malnutrition, cognitive impairment, oral dysbiosis, increased healthcare burden, and aspiration pneumonia, underscoring its systemic impact. Limited intervention evidence highlighted two promising programs: the CAMCAM program and the Oral Frailty Measures program, underscoring further intervention research. OF is a multifactorial syndrome with diverse adverse outcomes through bidirectional pathways. Future research should prioritize longitudinal designs to establish causality and develop integrated, culturally adapted prevention and intervention strategies.