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Associations of poor oral health with frailty and physical functioning in the oldest old: results from two studies in England and Japan

Lookup NU author(s): Dr Viviana AlbaniORCiD, Eftychia KotroniaORCiD, Professor Paula Moynihan, Professor Dame Louise Robinson, Professor Barbara Hanratty, Dr Andrew KingstonORCiD, Dr Toshi Iinuma, Dr Yasumichi Arai, Professor Sheena Ramsay



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021, The Author(s). Background: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old (> 85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan. Methods: The Newcastle 85+ Study in England (n = 853) and the Tokyo Oldest Old Survey on Total Health (TOOTH; n = 542) comprise random samples of people aged > 85 years. Oral health markers included tooth loss, dryness of mouth, difficulty swallowing and difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed; disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression. Results: In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for sex, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26–2.46); 2.52 (1.56–4.08); 2.89 (1.52–5.50); 2.59 (1.44–4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed; and complete tooth loss was associated with increased risk of frailty. Conclusion: Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.

Publication metadata

Author(s): Albani V, Nishio K, Ito T, Kotronia E, Moynihan P, Robinson L, Hanratty B, Kingston A, Abe Y, Takayama M, Iinuma T, Arai Y, Ramsay SE

Publication type: Article

Publication status: Published

Journal: BMC Geriatrics

Year: 2021

Volume: 21

Online publication date: 18/03/2021

Acceptance date: 11/02/2021

Date deposited: 26/07/2021

ISSN (electronic): 1471-2318

Publisher: BioMed Central Ltd


DOI: 10.1186/s12877-021-02081-5

PubMed id: 33736595


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Funder referenceFunder name
G0601333Medical Research Council (MRC)
R124/0509Dunhill Medical Trust
R03 DE028505–02
R592/0717Dunhill Medical Trust