Association of oral frailty with 1-year all-cause mortality in older patients with heart failure: A retrospective cohort study.

BACKGROUND&AIMS: Oral frailty has been conceptualized as an intermediate state of oral functional decline, and assessment with the Oral Frailty 5-item Checklist (OF-5) has been recommended, whereas evidence in heart failure (HF) populations remains unclear. We investigated the frequency of OF-5-defined oral frailty and its associations with swallowing-related muscle function and 1-year all-cause mortality in older patients with HF.

METHODS

This single-center retrospective study included consecutive patients aged 65 years or older who were hospitalized for HF. Patients were first classified as having limited oral intake status if the Food Intake LEVEL Scale was 7 or lower. Among those without limited oral intake status, oral frailty was defined as two or more OF-5 items, and the remaining patients were classified as robust. Outcomes were swallowing-related muscle function (maximal tongue pressure, geniohyoid muscle area, and geniohyoid muscle echogenicity) at discharge and 1-year all-cause mortality.

RESULTS

Of 319 screened patients, 269 were analyzed; 90 patients were robust (33.5%), 108 were oral frailty (40.1%), and 71 had limited oral intake status (26.4%). The median age was 83 (75-87) years, and 47.2% were women. In analysis of covariance, swallowing-related muscle function showed graded declines across robust, oral frailty, and limited oral intake status (P < 0.001 for all). In adjusted Cox regression, with robust as the reference, oral frailty and limited oral intake status were associated with higher mortality (oral frailty: hazard ratio [HR] 3.11, 95% confidence interval [CI] 1.08-8.95, P = 0.032; limited oral intake status: HR 8.22, 95% CI 2.89-23.34, P < 0.001).

CONCLUSION

OF-5-defined oral frailty was frequently observed in older patients with HF, accompanied by reduced swallowing-related muscle function, and was associated with higher 1-year all-cause mortality, suggesting that oral frailty assessment may serve as a valuable clinical marker for risk stratification at discharge.