Growing evidence supports the interdependence between oral health-related quality of life (OHRQoL) and formal social engagement (FSE) in later life. However, the causal direction of this relationship and potential gender differences therein remain underexplored. This study, informed by social causation and health selection perspectives within a social determinants of health framework, examines gender-specific patterns in the reciprocal relationship between OHRQoL and FSE among older adults in South Korea. A random-intercept cross-lagged panel model was applied to 3-wave panel data (2018, 2020, 2022) from 6,106 Korean adults aged ≥55 y. OHRQoL was assessed by the Geriatric Oral Health Assessment Index, validated for the Korean population. FSE was measured by the frequency of participation in structured organizational activities. The analysis identified significant bidirectional associations between OHRQoL and FSE at the within-person level, with distinct gender-specific patterns. Among men, better-than-usual OHRQoL predicted subsequent FSE, but the reverse path was not significant (health selection only). Among women, significant bidirectional associations were observed (social causation and health selection). These findings suggest gender-tailored interventions: alleviating oral health barriers to facilitate social reengagement for both genders, while leveraging social engagement to enhance OHRQoL specifically for women.
Sung et al. (2026) studied this question.