Longitudinal association between social frailty and poor oral health-related quality of life among middle-aged and older adults: Exploring the mediating role of cognitive function using a nationally representative cohort in the Republic of Korea.
TL;DR
Social frailty was negatively associated with subsequent OHRQoL among middle-aged and older adults and comprehensive interventions aimed at enhancing social engagement and cognitive function may be essential for the improvement of oral health outcomes.
Abstract
Background
Although the health implications of social frailty have drawn great interest, research on its relationship with oral health is scarce. The authors examined the relationship between social frailty and oral health-related quality of life (OHRQoL) and the mediating role of cognitive function.
Methods
The authors analyzed 5,227 middle-aged and older adults. Social frailty was measured using 5 domains and grouped as non-social frailty, pre-social frailty, and social frailty. Cognitive function and OHRQoL were measured using the Mini-Mental State Examination and the Geriatric Oral Health Assessment Index, respectively. Linear regression was used to analyze the association between social frailty and OHRQoL, and the mediating role of cognitive function was estimated using the mediation analysis, expressed as natural indirect effects.
Results
At baseline, 64.7%, 21.8%, and 13.5% of the participants had non-social frailty, pre-social frailty, and social frailty, respectively. Compared with non-social frailty, both pre-social frailty (β = -0.87; 95% CI, -1.54 to -0.32) and social frailty (β = -0.92; 95% CI, -1.66 to -0.03) were associated with poorer subsequent OHRQoL. The natural indirect effects of the mediating role of cognitive function was -0.11 (95% CI, -0.20 to -0.08) for pre-social frailty and -0.22 (95% CI, -0.37 to -0.16) for social frailty, accounting for 13.1% and 23.5% of the total associations, respectively.
Conclusions
Social frailty was negatively associated with subsequent OHRQoL among middle-aged and older adults. Poor cognitive function may partially explain this association. PRACTICAL IMPLICATIONS Comprehensive interventions aimed at enhancing social engagement and cognitive function may be essential for the improvement of oral health outcomes.