Association Between Oral Frailty and Health Indicators Using Data from the 2023 Korea National Health and Nutrition Examination Survey: A Cross-Sectional Study.

Background/Objectives: In this study, we aimed to investigate age-specific prevalence and patterns of oral frailty among Korean adults and examine its multidimensional associations with physical and mental health and health-related quality of life, from a life-course perspective. Methods: This cross-sectional study included 4459 adults aged ≥25 years from the 2023 Korea National Health and Nutrition Examination Survey. Oral frailty was defined as the presence of ≥4 deficits across 9 clinical and behavioral indicators. Associations of oral frailty with chronic diseases, appendicular skeletal muscle mass (ASM), psychological symptoms, and health-related quality of life were examined across age-stratified cohorts (25-44, 45-59, 60-74, and ≥75 years). Results: The prevalence of oral frailty was significantly higher in older age groups (8.2% at 25-44 years to 48.5% at ≥75 years, p < 0.001). Frail participants showed significantly higher prevalence of hypertension and diabetes and lower ASM, compared with non-frail participants. Difficulty pronouncing words and toothache experience showed the strongest contributions to the overall oral frailty score (p < 0.001). Oral frailty was also significantly associated with higher perceived stress and generalized anxiety, particularly among younger adults aged 25-44 years. Health-related quality of life was consistently lower in frail participants than in non-frail participants across all age groups (p < 0.001). Conclusions: Oral frailty is a multidimensional indicator associated with systemic aging, metabolic health, psychological distress, and reduced quality of life across the life course. These findings support the need for integrated, life-course-oriented oral health interventions beginning in early adulthood to prevent functional decline and promote healthy aging.