Samenvatting

Background: In frail older people with natural teeth factors like polypharmacy, reduced salivary flow,
a decrease of oral self-care, general healthcare issues, and a decrease in dental care utilization contribute to an
increased risk for oral complications. On the other hand, oral morbidity may have a negative impact on frailty.
Objective: This study explored associations between oral health and two frailty measures in community-dwelling
older people. Design: A cross-sectional study. Setting: The study was carried out in a Primary Healthcare Center
(PHC) in The Netherlands. Participants: Of the 5,816 persons registered in the PHC, 1,814 persons were eligible
for participation at the start of the study. Measurements: Two frailty measures were used: 1. Being at risk for
frailty, using Electronical Medical Record (EMR) data, and: 2. Survey-based frailty using ‘The Groningen
Frailty Indicator’ (GFI). For oral health measures, dental-record data (dental care utilization, dental status,
and oral health information) and self-reported oral problems were recorded. Univariate regression analyses
were applied to determine the association between oral health and frailty, followed by age- and sex-adjusted
multivariate logistic regressions. Results: In total 1,202 community-dwelling older people were included in the
study, 45% were male and the mean age was 73 years (SD=8). Of all participants, 53% was at risk for frailty
(638/1,202), and 19% was frail based on the GFI (222/1,202). A dental emergency visit (Odds Ratio (OR)=
2.0, 95% Confidence Interval (CI)=1.33;3.02 and OR=1.58, 95% CI=1.00;2.49), experiencing oral problems
(OR=2.07, 95% CI=1.52;2.81 and OR=2.87, 95% CI= 2.07;3.99), and making dietary adaptations (OR=2.66,
95% CI=1.31;5.41 and OR=5.49, 95% CI= 3.01;10.01) were associated with being at risk for frailty and surveybased
frailty respectively. Conclusions: A dental emergency visit and self-reported oral health problems are
associated with frailty irrespective of the approach to its measurement. Healthcare professionals should be aware
of the associations of oral health and frailty in daily practice.