ArticleBMC oral health2026
Association of frailty index with incident complete tooth loss among middle-aged and older Chinese adults: a longitudinal cohort study based on CHARLS.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTooth loss is a severe oral health condition among middle-aged and older adults and is associated with impaired mastication, nutritional problems, and reduced quality of life. Frailty-a state of increased vulnerability to adverse health outcomes-may represent an underexplored factor associated with oral health outcomes, but population-based evidence from China remains limited. This study aimed to evaluate the association between the 35-item Frailty Index (FI35) and incident complete tooth loss using data from the China Health and Retirement Longitudinal Study (CHARLS).
methodsA longitudinal cohort analysis using data from the 2015 and 2018 waves of the China Health and Retirement Longitudinal Study was conducted. Frailty and covariates were assessed at baseline in 2015, and incident complete tooth loss was assessed at follow-up in 2018. Participants who met the definition of complete tooth loss at baseline were excluded. Multivariable logistic regression was used to assess the association between FI35 (as a continuous variable and in quartiles) and incident complete tooth loss, with sequential adjustment for demographic characteristics, lifestyle factors, and comorbidities. Restricted cubic splines were employed to explore nonlinear dose-response patterns. Subgroup analyses and interaction tests were applied to examine effect modification.
resultsDuring the three-year follow-up, 603 (6.03%) participants developed incident complete tooth loss. In the fully adjusted model, Each 0.1-unit increase in baseline FI35 was associated with 16% higher odds of incident complete tooth loss (OR = 1.16, 95% CI: 1.07-1.25, P < 0.001). Compared with participants in the lowest quartile, those in the highest quartile had 78% higher odds of incident complete tooth loss (OR = 1.78, 95% CI: 1.35-2.33; P for trend < 0.001). Restricted cubic spline analysis suggested a nonlinear association (P for overall = 0.002, P for nonlinear = 0.034). Exploratory subgroup analyses suggested possible heterogeneity by age (P for interaction = 0.032), although this finding should be interpreted cautiously.
conclusionHigher baseline FI35 was associated with greater odds of incident complete tooth loss during the three-year follow-up among middle-aged and older Chinese adults. Further studies incorporating objective oral-health assessments are needed to confirm these findings and clarify the underlying pathways.
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