Article ID: JPR_D_25_00248
Purpose: The epidemiological mechanisms linking poor oral health and oral function to declining well-being among older adults remain unclear. This study examined the association between oral frailty and well-being among community-dwelling older adults in Japan and explored potential mediating pathways across the physical, psychological, and social domains.
Methods: Data were drawn from the 2023 wave of the Itabashi Longitudinal Study on Aging, including participants aged ≥70 years. Oral frailty was assessed using the Oral Frailty 5-item Checklist. Generalized structural equation modeling (GSEM) was used to estimate the indirect effects of oral frailty on well-being, measured using the Philadelphia Geriatric Center Morale Scale (PGCMS) and the Cantril Self-Anchoring Striving Scale (CSASS), through physical frailty, undernutrition, depressive symptoms, cognitive impairment, and social isolation.
Results: A total of 849 older adults (503 men and 346 women; mean age = 75.8 years) were analyzed. The prevalence of oral frailty was 40.2%. The PGCMS showed significant indirect associations between oral frailty and two candidate mediators in the GSEM: undernutrition (b = -0.27, 95% confidence interval [CI]: -0.54 to -0.01) and depressive symptoms (b = -1.35, 95% CI: -1.96 to -0.74). Similar findings were observed for the CSASS, with depressive symptoms (b = -0.66, 95% CI: -0.96 to -0.36) and social isolation (b = -0.14, 95% CI: -0.25 to -0.03) emerging as significant mediators.
Conclusions: Oral frailty is indirectly associated with poorer well-being in older Japanese adults, with GSEM estimates suggesting biological and social pathways involving nutritional status, mental health, and social engagement.
