Systematic review and meta-analysis of risk factors for oral frailty

Background: Oral frailty can lead to complications such as eating disorders and sarcopenia, thereby significantly impairing patients’ health. While numerous studies have been conducted to identify risk factors for oral frailty, the results remain inconsistent due to variability in study populations, and certain risk factors remain controversial. Methods: Eight databases, including PubMed, EMBASE, Web of Science, Cochrane Library, CNKI (China National Knowledge Infrastructure), VIP (China Science and Technology Journal Database), CBM (China Biology Medicine disc), and Wanfang Databases, were thoroughly searched from database inception to August 1, 2024 to identify studies reporting risk factors for oral frailty. Odds ratios (OR) and 95% confidence intervals (CI) were pooled using RevMan 5.4 to identify variables influencing the incidence of oral frailty. Results: A total of 14 studies involving 12,297 participants were included, among whom 4540 presented with oral frailty. Forty risk factors were extracted from these studies. Among them, 10 risk factors were eligible for meta-analysis, whereas the remaining 30 were excluded from the analysis due to being reported in fewer than 3 studies. The meta-analysis revealed that nine of the ten risk factors, namely age, gender, smoking, denture use, xerostomia, low oral health awareness, malnutrition, unbalanced diet, and physical frailty, were significantly associated with oral frailty. Conclusion: This study identified risk factors for oral frailty and validated several factors already included in existing assessment scales, such as the use of dentures and xerostomia. Additionally, novel factors such as gender and age were identified. Taken together, these results may assist in the timely identification of individuals at risk for oral frailty and prevent its onset, as well as enhance current risk assessment tools.