Heterogeneous Trajectories of Oral Frailty Among Institutionalized Older Adults: A 6‐Month Latent Growth Mixture Modelling Study

BACKGROUND: Oral frailty describes an emerging geriatric oral condition featuring progressive oral function decline linked to adverse health outcomes among older adults. Older adults living in long-term care facilities are particularly vulnerable due to advanced age, multimorbidity and reduced self-care capacity. However, longitudinal patterns of oral frailty progression and individual heterogeneity remain unclear. OBJECTIVES: This study aimed to identify distinct longitudinal trajectories of oral frailty among older adults residing in long-term care facilities and to examine baseline clinical characteristics associated with different trajectory memberships. METHODS: A prospective longitudinal study was conducted among 295 older adults from six long-term care facilities in Chengdu, China, between March and December 2025. Oral frailty was assessed using the Oral Frailty Index-8 (OFI-8) at baseline and at 1-, 3- and 6-month follow-ups. Latent growth mixture modelling (LGMM) was used to identify oral frailty trajectories. RESULTS: Three distinct oral frailty trajectories were identified: a low-level persistent stable group (46.3%), a moderate-level gradual recovery group (34.4%) and a high-level progressive deterioration group (19.3%). Cognitive impairment, nutritional status, insomnia, number of chronic diseases and long-term alcohol consumption were key clinical indicators distinguishing the three trajectory groups. CONCLUSION: Oral frailty progression among older adults in long-term care facilities shows substantial heterogeneity. Trajectory-based assessment incorporating cognitive, nutritional and chronic disease-related indicators may facilitate early identification of high-risk individuals and support personalized oral health interventions.