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Association between oral health markers and decline in muscle strength and physical performance in later life: longitudinal analyses of two prospective cohorts from the UK and the USA

Lookup NU author(s): Dr Rachel Kimble, Gillian McLellan, Professor John Mathers, Professor Sheena Ramsay



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


© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Poor oral health could be associated with changes in musculoskeletal health over time. This aim of this study was to investigate the longitudinal relationship between oral health and decline in physical function in later life. Methods: We did a prospective analysis of two cohorts of older adults (aged 70 years or older) including men from the British Regional Heart Study (BRHS; n=612), and men and women from the Health, Aging and Body Composition (Health ABC) Study (n=1572), followed up for about 8 years. Data were available for clinical or self-reported oral health measures, muscle (grip) strength, and physical performance (chair stand and gait speed). ANCOVA models were used to assess the association between oral health and follow-up physical function scores. Multivariate logistic regression models were used to examine the associations between oral health and decline in physical function over the follow-up period. In the BRHS, changes in oral health and physical function were also assessed. All models were adjusted for relevant sociodemographic, behavioural, and health-related factors. Findings: In the BRHS, complete tooth loss and difficulty eating were associated with weaker grip strength at follow-up, and periodontal status was associated with decline in gait speed. In the Health ABC Study, complete tooth loss, poor self-rated oral health, and the presence of one oral health problem were associated with slower gait speed at follow-up. In both studies, dry mouth was associated with declines in physical function. In the BRHS, deterioration of dentition (tooth loss) over the follow-up period was associated with decline in chair stand speed (adjusted odds ratio 2·34 [95% CI 1·20–4·46]), as was deterioration in difficulty eating (2·41 [1·04–5·60]). Interpretation: Oral health problems are associated with poorer physical function and greater decline in physical function in older adults, and could be an indicator of individuals at risk of reduced physical capacity and subsequent frailty and disability in later life. Funding: The Dunhill Medical Trust and the US National Institutes of Health—National Institute of Dental and Craniofacial Research.

Publication metadata

Author(s): Kimble R, McLellan G, Lennon LT, Papacosta AO, Weyant RJ, Kapila Y, Mathers JC, Wannamathee SG, Whincup PH, Ramsay SE

Publication type: Article

Publication status: Published

Journal: The Lancet Healthy Longevity

Year: 2022

Volume: 3

Issue: 11

Pages: e777-e788

Print publication date: 01/11/2022

Online publication date: 01/11/2022

Acceptance date: 02/04/2022

Date deposited: 22/11/2022

ISSN (electronic): 2666-7568

Publisher: Elsevier Ltd


DOI: 10.1016/S2666-7568(22)00222-7


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Funder referenceFunder name
British Heart Foundation (BHF)
Dunhill Medical Trust
National Institute of Nursing
R03 DE028505-02
US National Institute on Aging
US National Institutes of Health—National Institute of Dental and Craniofacial Research