# Association of oral frailty and its dimensions with cognitive impairment among older adults in China: a cross-sectional study

**Authors:** Yanru Chen, Lisheng Xu, Fan Liu, Ling Zhang

PMC · DOI: 10.1186/s12903-025-07507-9 · 2026-03-19

## TL;DR

Poor oral health and oral frailty are linked to cognitive decline in older adults in China, according to a study of 407 participants.

## Contribution

This study identifies specific oral frailty dimensions associated with cognitive impairment in older adults.

## Key findings

- Oral frailty is associated with an increased risk of cognitive impairment (OR = 1.89).
- Chewing difficulty and low social participation are strongly linked to cognitive impairment.
- Fewer remaining teeth and lower oral health scores correlate with cognitive decline.

## Abstract

Growing evidence highlights that poor oral health may increase the risk of cognitive decline. However, the association of oral frailty and its dimensions with cognitive function remains under-explored. This study aimed to evaluate the association of oral frailty and its dimensions with cognitive impairment among older adults in China.

This cross-sectional study used convenience sampling to recruit older adults aged ≥ 60 years who received routine oral examinations at the West China Hospital of Stomatology, Sichuan University, from June 2022 to March 2024. Cognitive function was assessed with the Montreal Cognitive Assessment Scale (MoCA), and the oral frailty status was evaluated using the Oral Frailty Index-8 (OFI-8) scale. Binary logistic regression was performed to analyze the independent association between oral frailty and cognitive impairment, with adjustment for potential confounding variables.

A total of 407 older adults were included, revealing a prevalence rate of 42.0% for cognitive impairment. In the fully adjusted binary logistic regression model, oral frailty was associated with an increased risk of cognitive impairment (OR = 1.89, 95%CI: 1.43–2.50). As to the specific dimensions, chewing difficulty (OR = 2.98, 95%CI: 1.86–4.78), low social participation (OR = 4.69, 95%CI: 1.14–19.23), the number of remaining teeth (OR = 0.91, 95%CI: 0.88–0.95), and the GOHAI score (OR = 0.95, 95%CI: 0.92–0.98) were found independent association with cognitive impairment (p < 0.05).

Oral frailty is closely associated with cognitive impairment in older adults. Further longitudinal research is required to investigate the underlying mechanisms.

## Full-text entities

- **Diseases:** physical dysfunction (MESH:D059445), of weight (MESH:D015431), tooth loss (MESH:D016388), dementia (MESH:D003704), chewing disorder (MESH:D009358), masticatory dysfunction (MESH:C563600), geriatric syndrome (MESH:D013577), inflammation (MESH:D007249), difficulty in swallowing (MESH:D003680), memory loss (MESH:D008569), hearing impairment (MESH:D034381), Fatigue (MESH:D005221), Alzheimer's disease (MESH:D000544), self-care impairment (MESH:C000657744), oral health deficits (MESH:D009461), toothache (MESH:D014098), self-care (MESH:D003428), chewing difficulty (MESH:D051346), hypertension (MESH:D006973), dental caries (MESH:D003731), Depression (MESH:D003866), periodontal disease (MESH:D010510), heart disease (MESH:D006331), ADL impairment (MESH:D060825), dry mouth symptoms (MESH:D014987), stroke (MESH:D020521), oral diseases (MESH:D009059), GDS-15 (MESH:D012559), COPD (MESH:D029424), Frailty (MESH:D000073496), diabetes (MESH:D003920), hearing or visual problems (MESH:D006311), CI (MESH:D003072), gum pain (MESH:D010146), intellectual disabilities (MESH:D008607)
- **Chemicals:** alcohol (MESH:D000438)
- **Species:** Arachis hypogaea (goober, species) [taxon 3818], Homo sapiens (human, species) [taxon 9606]

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC13032528/full.md

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Source: https://tomesphere.com/paper/PMC13032528