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Objectives <p>This study aimed to map the complex relationships among physiological, psychological, and social factors of oral frailty using network analysis. The primary goal was to identify the most central and influential elements within this network to guide future intervention strategies.</p> Materials and methods <p>A cross-sectional study included 991 community-dwelling older adults in Jiangsu Province, China. Data were collected on oral frailty (OFI-8), oral health self-efficacy (GSEOH), depressive symptoms (GDS-5), family support (APGAR), personal mastery (PMS), and nutritional appetite (SNAQ). A Gaussian Graphical Model network was constructed, and centrality indices were calculated to identify key nodes.</p> Results <p>The analysis revealed a stable network where personal mastery (PMS), nutritional appetite (SNAQ), and oral health self-efficacy (GSEOH) emerged as the most central nodes. The strongest connection was found between GSEOH and SNAQ, highlighting a key psycho-physiological link. Notably, oral frailty (OFI) exhibited lower centrality and was negatively associated with these core psychosocial resources.</p> Conclusions <p>Oral frailty should be conceptualized as an outcome of dysregulation within a broader biopsychosocial system, rather than a central driver. Personal mastery, nutritional appetite, and oral health self-efficacy form a critical, interconnected core. A holistic approach strengthening these hubs may be more effective in managing oral frailty than focusing on oral symptoms alone.</p> Clinical relevance <p>This study advocates for a clinical shift from reactive symptom management to proactively enhancing older adults’ psychological resources, such as personal mastery. Interventions targeting the feedback loop between nutritional appetite and self-efficacy represent a promising strategy to prevent oral frailty and promote healthy aging.</p>

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Mapping the physiological, psychological and social landscape of the oral frailty network: a cross-sectional network analysis

  • 期刊论文

  • 发表日期：

    2026年1月7日

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  • Sichen Xia,
  • Ying Tao,
  • Guangrui Cao,
  • Yuanrong Wang,
  • Qiantong Hang,
  • Yichen Jiang,
  • Wenbo Sun,
  • Hua Wang,
  • Xian Chen

摘要

Objectives

This study aimed to map the complex relationships among physiological, psychological, and social factors of oral frailty using network analysis. The primary goal was to identify the most central and influential elements within this network to guide future intervention strategies.

Materials and methods

A cross-sectional study included 991 community-dwelling older adults in Jiangsu Province, China. Data were collected on oral frailty (OFI-8), oral health self-efficacy (GSEOH), depressive symptoms (GDS-5), family support (APGAR), personal mastery (PMS), and nutritional appetite (SNAQ). A Gaussian Graphical Model network was constructed, and centrality indices were calculated to identify key nodes.

Results

The analysis revealed a stable network where personal mastery (PMS), nutritional appetite (SNAQ), and oral health self-efficacy (GSEOH) emerged as the most central nodes. The strongest connection was found between GSEOH and SNAQ, highlighting a key psycho-physiological link. Notably, oral frailty (OFI) exhibited lower centrality and was negatively associated with these core psychosocial resources.

Conclusions

Oral frailty should be conceptualized as an outcome of dysregulation within a broader biopsychosocial system, rather than a central driver. Personal mastery, nutritional appetite, and oral health self-efficacy form a critical, interconnected core. A holistic approach strengthening these hubs may be more effective in managing oral frailty than focusing on oral symptoms alone.

Clinical relevance

This study advocates for a clinical shift from reactive symptom management to proactively enhancing older adults’ psychological resources, such as personal mastery. Interventions targeting the feedback loop between nutritional appetite and self-efficacy represent a promising strategy to prevent oral frailty and promote healthy aging.