Influencing factors of oral frailty in elderly patients with head and neck cancer: a multicenter, cross-sectional study

OBJECTIVES: This study aimed to investigate the current situation of oral frailty (OF) in elderly patients with head and neck cancer (HNC) in China and analyse its influencing factors. METHODS: A total of 332 elderly patients with HNC were recruited from four tertiary hospitals in Jiangsu, China. Oral frailty was assessed using the Oral Frailty Index-8 (OFI-8). A general information questionnaire, the Frailty Screening Scale (FRAIL), Nutritional Risk Screening 2002 (NRS 2002), number of remaining natural teeth(TN), and the Simplified Nutritional Appetite Questionnaire (SNAQ) were used to investigate factors associated with oral frailty. A nomogram was constructed as a visual representation of the final multivariable logistic regression model. RESULTS: The prevalence of OF among elderly patients with HNC was 68.98%. Multivariate logistic regression analysis revealed that radiotherapy (OR = 3.163, 95% CI: 1.239-8.073), having three or more comorbidities (OR = 4.641, 95% CI: 2.055-10.481) and NRS 2002 score ≥ 3 (OR = 3.010, 95% CI: 1.037-8.735) were associated with a higher likelihood of oral frailty. In contrast, SNAQ score > 14 (OR = 0.303, 95% CI: 0.108-0.854), higher monthly income (≥ 6,000 yuan; OR = 0.211, 95% CI: 0.064-0.698) and having ≥ 20 remaining natural teeth (TN ≥ 20; OR = 0.052, 95% CI: 0.017-0.156) were associated with a lower likelihood of oral frailty. CONCLUSION: Oral frailty is highly prevalent among elderly patients with HNC. The main associated factors include radiotherapy, appetite, nutrition status, number of remaining natural teeth, having three or more comorbidities, and income. Routine screening and multidisciplinary interventions targeting these modifiable factors may help prevent or delay OF in this vulnerable population.