A systematic review and gap analysis of frailty and oral health characteristics in older adults: A call for clinical translation

Lyubov D. Slashcheva, Erika Karjalahti, Leslie C. Hassett, Barbara Smith, Alanna M. Chamberlain

Research output: Contribution to journalReview articlepeer-review


Objective: This systematic review updates the evidence for association between oral health characteristics and frailty status, identifying gaps in translational dental research and application of frailty assessment into clinical practice. Background: Clinicians have little guidance on stage-appropriate dental treatment for medically complex older adults. Oral health characteristics have been associated with frailty status, determined through validated assessment tools representing a concise measure of health. Translation of frailty assessment into dental practice has not been the focus of previous reviews. Methods: Utilising the PRISMA framework for systematic reviews, a comprehensive database search identified articles describing the association of interest. Those included were cross-sectional or longitudinal, in English, included participants aged 50 years or older, used validated frailty assessments and measured clinically relevant oral health outcomes. From 835 screened articles, 26 full-text articles were eligible for quality appraisal and synthesis. Results: Frailty prevalence ranged from 8.5% to 66.0%. Most studies utilised the Fried frailty criteria. Qualitative synthesis of 17 cross-sectional and nine longitudinal studies demonstrated significant covariate-adjusted association between frailty status and number of teeth, chewing ability, prosthetic characteristics, dental caries, periodontitis, dental utilisation and oral health-related quality of life factors. Variability in findings reflected study sample diversity based on country of study origin, age at recruitment, sample size, frailty assessment type, use of clinical versus self-reported outcome measures and differences in statistical analysis. Conclusion: Despite robust evidence of association with oral health characteristics, frailty assessment has yet to be sufficiently applied to translational dental research and clinical practice.

Original languageEnglish (US)
Pages (from-to)338-350
Number of pages13
Issue number4
StatePublished - Dec 2021


  • clinical assessment tools
  • clinical translation
  • frailty
  • oral health
  • systematic review
  • systemic health

ASJC Scopus subject areas

  • General Dentistry
  • Geriatrics and Gerontology


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