Prevalence and influencing factors of oral frailty in older adults with diabetes: a systematic review and meta-analysis

Objective To systematically evaluate the prevalence and influencing factors of oral frailty in older adults with diabetes. Methods We systematically searched for studies on the prevalence and influencing factors of oral frailty in older adults with diabetes across databases including CNKI, Wanfang Database, VIP Database, China Biology Medicine Disc (CBM), PubMed, Embase, Web of Science, CINAHL, and the Cochrane Library, from database inception to August 7, 2025. Results Nine studies were ultimately included, involving a total of 2,395 patients. The meta-analysis showed that the prevalence of oral frailty in older adults with diabetes was 52% (95% CI: 0.43–0.61, I 2 = 95.15%, P < 0.01). Influencing factors included age [odds ratio (OR) = 3.91, 95% CI: 2.13–5.68], smoking (OR = 4.64, 95% CI: 1.95–7.33), polypharmacy (OR = 8.70, 95% CI: 3.26–14.14), duration of diabetes (OR = 3.29, 95% CI: 1.55–5.04), glycated hemoglobin (HbA1c) level (OR = 3.61, 95% CI: 1.47–5.74), number of remaining teeth (OR = 11.84, 95% CI: 4.47–19.22), and oral health-related self-efficacy (OR = 0.18, 95% CI: 0.10–0.27). Conclusion The prevalence of oral frailty is high among older adults with diabetes and is influenced by multiple factors. Healthcare providers should incorporate the assessment of oral frailty into routine dynamic monitoring for these patients. Based on individual conditions and clinical contexts, personalized, comprehensive, and early intervention plans should be developed through a multidisciplinary approach to prevent or delay the progression of oral frailty. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251119100 , identifier CRD420251119100.