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<p>Frailty is an age-associated state of reduced physiological reserve that increases vulnerability to adverse outcomes following acute insults such as infections, injuries, trauma, and surgery. It is associated with physical disability, dependence, hospitalisation, and premature mortality. Frailty encompasses physical, psychological, social, and oral health domains and is potentially reversible, particularly in its early stages. Given the adverse outcomes associated with frailty, there is increasing interest in identifying pre-frailty and its associated risk factors among community-dwelling older adults. This study aims to identify risk factors associated with pre-frailty in community-dwelling older adults. A total of 416 community-dwelling older adults underwent comprehensive health screening to identify modifiable risk factors associated with pre-frailty. Assessments included demographic and clinical characteristics, physical performance tests, and oral health evaluations. Potentially modifiable risk factors independently associated with pre-frailty included possible sarcopenia (OR 9.361, 95% confidence interval&#xa0;[CI]&#xa0;4.267–20.534, <i>p</i> &lt; 0.001), reduced lower limb strength, as reflected by a five-times sit-to-stand test (5xSTS) ≥ 12&#xa0;s (OR 2.398, 95% CI 1.359–4.229, <i>p</i> = 0.003), poor oral health (OHAT ≥ 7) (OR 2.278, 95% CI 1.047–4.955, <i>p</i> = 0.038), and cognitive impairment (AD8 ≥ 2) (OR 3.947, 95% CI 2.142–7.274, <i>p</i> &lt; 0.001). Non-modifiable risk factors associated with pre-frailty included 6&#xa0;years or fewer of formal education (OR 3.272, 95% CI 1.855–5.770, <i>p</i> &lt; 0.001) and a history of falls within the preceding 12&#xa0;months (OR 3.138, 95% CI 1.221–8.068, <i>p</i> = 0.017). After adjustment for education, possible sarcopenia (OR 3.482, 95% CI 1.477–8.211, <i>p</i> = 0.004), cognitive impairment (OR 4.875, 95% CI 2.028–11.721, <i>p</i> &lt; 0.001) and lower limb strength (OR 5.753, 95% CI 2.402–13.782, <i>p</i> &lt; 0.001) were associated with pre-frailty. All cases of possible sarcopenia, cognitive impairment, and poor oral health identified during screening were previously undiagnosed. Possible sarcopenia, poor oral health, and cognitive impairment are potentially modifiable risk factors associated with pre-frailty. Their high rate of underdiagnosis highlights the importance of targeted case-finding among pre-frail community-dwelling older adults to facilitate early intervention.</p>

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Undiagnosed possible sarcopenia, poor oral health and cognitive impairment among community-dwelling pre-frail older adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月14日

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  • RongLi Wang,
  • Louis Y. Tee,
  • Si Ching Lim

摘要

Frailty is an age-associated state of reduced physiological reserve that increases vulnerability to adverse outcomes following acute insults such as infections, injuries, trauma, and surgery. It is associated with physical disability, dependence, hospitalisation, and premature mortality. Frailty encompasses physical, psychological, social, and oral health domains and is potentially reversible, particularly in its early stages. Given the adverse outcomes associated with frailty, there is increasing interest in identifying pre-frailty and its associated risk factors among community-dwelling older adults. This study aims to identify risk factors associated with pre-frailty in community-dwelling older adults. A total of 416 community-dwelling older adults underwent comprehensive health screening to identify modifiable risk factors associated with pre-frailty. Assessments included demographic and clinical characteristics, physical performance tests, and oral health evaluations. Potentially modifiable risk factors independently associated with pre-frailty included possible sarcopenia (OR 9.361, 95% confidence interval [CI] 4.267–20.534, p < 0.001), reduced lower limb strength, as reflected by a five-times sit-to-stand test (5xSTS) ≥ 12 s (OR 2.398, 95% CI 1.359–4.229, p = 0.003), poor oral health (OHAT ≥ 7) (OR 2.278, 95% CI 1.047–4.955, p = 0.038), and cognitive impairment (AD8 ≥ 2) (OR 3.947, 95% CI 2.142–7.274, p < 0.001). Non-modifiable risk factors associated with pre-frailty included 6 years or fewer of formal education (OR 3.272, 95% CI 1.855–5.770, p < 0.001) and a history of falls within the preceding 12 months (OR 3.138, 95% CI 1.221–8.068, p = 0.017). After adjustment for education, possible sarcopenia (OR 3.482, 95% CI 1.477–8.211, p = 0.004), cognitive impairment (OR 4.875, 95% CI 2.028–11.721, p < 0.001) and lower limb strength (OR 5.753, 95% CI 2.402–13.782, p < 0.001) were associated with pre-frailty. All cases of possible sarcopenia, cognitive impairment, and poor oral health identified during screening were previously undiagnosed. Possible sarcopenia, poor oral health, and cognitive impairment are potentially modifiable risk factors associated with pre-frailty. Their high rate of underdiagnosis highlights the importance of targeted case-finding among pre-frail community-dwelling older adults to facilitate early intervention.