Heterogeneous Trajectories of Oral Frailty Among Institutionalized Older Adults: A 6-Month Latent Growth Mixture Modelling Study.

BACKGROUND

Oral frailty describes an emerging geriatric oral condition featuring progressive oral function decline linked to adverse health outcomes among older adults. Older adults living in long-term care facilities are particularly vulnerable due to advanced age, multimorbidity and reduced self-care capacity. However, longitudinal patterns of oral frailty progression and individual heterogeneity remain unclear.

OBJECTIVES

This study aimed to identify distinct longitudinal trajectories of oral frailty among older adults residing in long-term care facilities and to examine baseline clinical characteristics associated with different trajectory memberships.

METHODS

A prospective longitudinal study was conducted among 295 older adults from six long-term care facilities in Chengdu, China, between March and December 2025. Oral frailty was assessed using the Oral Frailty Index-8 (OFI-8) at baseline and at 1-, 3- and 6-month follow-ups. Latent growth mixture modelling (LGMM) was used to identify oral frailty trajectories.

RESULTS

Three distinct oral frailty trajectories were identified: a low-level persistent stable group (46.3%), a moderate-level gradual recovery group (34.4%) and a high-level progressive deterioration group (19.3%). Cognitive impairment, nutritional status, insomnia, number of chronic diseases and long-term alcohol consumption were key clinical indicators distinguishing the three trajectory groups.

CONCLUSION

Oral frailty progression among older adults in long-term care facilities shows substantial heterogeneity. Trajectory-based assessment incorporating cognitive, nutritional and chronic disease-related indicators may facilitate early identification of high-risk individuals and support personalized oral health interventions.