Oral frailty and bite force in physically active older adults: functional insights into healthy aging

Abstract

Abstract Background Oral frailty is associated with adverse health outcomes in the elderly. Bite force has been proposed as a functional indicator of oral and systemic decline. Methods A cross-sectional study was conducted with 500 physically active older adults living in the community from Brazil and Portugal. Oral frailty was assessed using the Oral Frailty Index-8 (OFI-8), and bite force was measured with mandibular dynamometry. Associations between variables were analyzed using multivariable logistic regression and receiver operating characteristic (ROC) curve analysis. Normality was assessed using the Shapiro–Wilk test. Results The prevalence of oral frailty was 48.0%. Participants with oral frailty had significantly lower bite force than those without oral frailty (16.50 ± 6.35 vs. 21.08 ± 7.12 kgf; p < 0.001; Cohen's d = 0.61). Bite force was inversely associated with oral frailty (OR = 0.93; 95% CI 0.91–0.95), with each 1 kgf increase in bite force associated with 7% lower odds of oral frailty. An inverse gradient in the prevalence of oral frailty was observed across increasing bite force quartiles. ROC analysis showed modest discriminatory capacity (area under the curve = 0.669), with a sample-specific exploratory cut-off of 17.1 kgf (sensitivity 56.3%, specificity 71.5%). Conclusions Bite force was inversely associated with oral frailty after adjustment for age, sex, and BMI in physically active older adults and may represent a simple, noninvasive functional measure that could complement oral health assessment in community settings. Additional longitudinal and validation studies are needed to evaluate its predictive value, reproducibility, and clinical utility.

The authors' abstract, as published at the source. BMC Oral Health, 2026 · DOI ↗