# Role of Posterior Occlusal Support in the Development of Frailty Among Japanese Adults: A Longitudinal Cohort Study

## TL;DR

Poor dental support in the back teeth is linked to a higher risk of frailty in older Japanese adults, suggesting oral health impacts overall aging.

## Contribution

This study establishes a novel association between posterior occlusal support and frailty progression in a large Japanese cohort.

## Key findings

- Frailty prevalence increased with reduced posterior occlusal support (12.1% in Eichner C vs. 4.9% in Eichner A).
- Eichner C had a 1.39 higher odds of frailty compared to Eichner A after adjusting for confounders.
- The association between occlusal support and frailty was stronger in women than in men.

## Abstract

Recent studies have suggested that masticatory function may influence frailty progression. However, the relationship between posterior occlusal support and frailty remains underexplored. We aimed to evaluate the association between the loss of posterior occlusal support and frailty in a large cohort of Japanese adults.

This retrospective cohort study used data from the JMDC Claims Database. We included 386 270 individuals aged ≥ 40 years who underwent both specific health checkups and dental visits in 2016, with follow‐up data available through 2020. We categorized posterior occlusal support using the Eichner classification (A, all support zones intact; B, partial support zones; C, no functional support zones). We assessed frailty annually using the claims‐based frailty index (CFI) (a deficit accumulation‐type frailty measure). We used generalized estimating equations to evaluate the association between occlusal support and frailty after adjusting for potential confounders.

At baseline, the mean age was 49.6 (standard deviation, 7.2) years, and 47.4% of the participants were women. The prevalence of frailty was 4.9%, 9.5%, and 12.1% in the Eichner A, B, and C groups, respectively. Compared to Eichner A, the adjusted odds ratios (ORs) for frailty were 1.21 (95% confidence interval [CI], 1.13–1.30) for Eichner B and 1.39 (95% CI, 1.21–1.59) for Eichner C. This relationship was stronger among women than men.

Reduced posterior occlusal support is independently associated with an increased risk of frailty. These findings underscore the importance of oral health in preventing physical debilitation and suggest incorporating early dental interventions into health strategies for older populations.

Loss of posterior occlusal support was independently associated with an increased risk of frailty in a nationwide longitudinal analysis, highlighting the systemic importance of maintaining functional occlusion to promote healthy aging.