Herb Howard C. Hernandez, Celestine Lim, Jun Pei Lim, Jia Qian Chia, Kok‐Yang Ang, A. Yeo, Cai Tan, Wee Shiong Lim, Justin Chew
BACKGROUND AND AIMS: The oral frailty index-8 (OFI-8) is a measure of oral frailty to identify impaired oral function. However, its validity and associations with health outcomes remain unclear. We aim to evaluate its construct validity and associations with appetite, muscle health, falls, functional outcomes, and quality of life (QoL). METHODS: Cross-sectional analysis of 300 community-dwelling older adults (mean age 67.4 ± 7.10 years; 68.7% female). Exploratory factor analysis (EFA) assessed OFI-8's factor structure. Participants were classified as oral non-frail (ONF), pre-frail (OPF), or frail (OF) based on total scores. Associations with outcomes were assessed using logistic regression, adjusted for relevant covariates. Outcomes included appetite (SNAQ), muscle health (DEXA muscle mass, handgrip strength, SARC-F), falls risk (STEADI), function (IADL), life-space mobility (LSA), mood (GDS), and QoL (EQ-5D-5L). RESULTS: EFA revealed OFI-8's 3-factor structure: swallowing and oral conditions, dental care, and dietary and social habits. Prevalence of ONF, OPF, and OF was 62%, 16%, and 22%, respectively. Compared to ONF, OF showed worse appetite, handgrip strength, SARC-F scores, falls risk, IADL function, and mood (all p < 0.05). In adjusted models, OF was associated with poor appetite (OR = 1.97, 95% CI: 1.07-3.65), increased falls risk (OR = 2.64, 95% CI: 1.21-5.74), and low mood (OR = 5.51, 95% CI: 2.07-14.69). OPF was not associated with any outcomes. No differences were observed across groups in muscle mass, LSA, or QoL. CONCLUSION: Our findings provide preliminary support for OFI-8's validity as a multi-dimensional tool to identify community-dwelling older persons with oral frailty, which is associated with adverse outcomes. Further research is needed to refine cut-offs and evaluate longitudinal predictive validity.