ArticleBMC oral health2025
Oral frailty and nutritional appetite in older adults: a cross-sectional, moderated mediation model of oral self-efficacy and personal mastery.
Article in BMC oral health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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5 authors.
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Abstract
backgroundOral frailty is significantly associated with poor appetite in older adults. While the underlying psychological mechanisms are thought to be universal, their expression can be shaped by local contexts. This study investigated these mechanisms in China, where population aging and specific healthcare system characteristics create a pressing need for such research. This study examined the mediating role of oral self-efficacy and the moderating role of personal mastery in the relationship between oral frailty and nutritional appetite among older Chinese adults.
methodsThis cross-sectional study was conducted from January 17 to February 17, 2025, in Jiangsu Province, China, involving 959 community-dwelling older adults ≥ 60 years. Participants were recruited via convenience and snowball sampling from five diverse communities. Data were collected using an online questionnaire hosted on Wenjuanxing (Changsha Ranxing Information Technology Co., Ltd.; Changsha, China). We used the Oral Frailty Index-8, Geriatric Self-Efficacy Scale for Oral Health, Personal Mastery Scale, and Simplified Nutritional Appetite Questionnaire. Descriptive statistics, correlation analyses, and multiple linear regressions were performed using SPSS Statistics (Version 26.0; IBM Corp., Armonk, NY, USA). Mediation and moderated mediation analyses were conducted using Hayes' PROCESS macro (Models 4 and 8).
resultsOral frailty was negatively associated with nutritional appetite (β = -0.230, P < 0.001). Oral self-efficacy significantly mediated this relationship (indirect effect = -0.099, 95% CI [-0.129, -0.073]), accounting for 43.11% of the total effect. Personal mastery significantly moderated this pathway. The negative association of oral frailty with both oral self-efficacy and nutritional appetite was attenuated at higher levels of personal mastery. The overall index of moderated mediation was significant (Index = 0.022, 95% CI [0.007, 0.037]).
conclusionsOral self-efficacy is a key mechanism linking oral frailty to nutritional appetite, and personal mastery is a protective psychological resource that buffers this detrimental association. These findings highlight that interventions to improve nutritional outcomes in older adults should not only address physical oral health but also aim to enhance psychological resources like self-efficacy and a sense of personal control.
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