The mediating effect of depression on the relationship between jaw pain and frailty among Chinese older adults: a cohort study based on CLHLS from 2014 to 2018 (Preprint)

BACKGROUND Although there has been considerable research on the association between oral health, depression, and frailty, a majority of studies have been cross-sectional, and no research has investigated the relationship between all three. OBJECTIVE The purpose of this cohort study was to explore the association between jaw pain and frailty, and the mediating effect of depressive symptoms in Chinese older adults METHODS Based on the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2014 to 2018, 2134 Chinese people aged 60 and over were included in this study. Jaw pain, depressive symptoms, frailty, and other variables were assessed by a self-reported questionnaire. Logistic regressions were conducted to test the association between jaw pain, depression, and frailty. Path analysis was applied to examine the mediating role of depression. RESULTS The prevalence of frailty was 16.73% in 2018. Jaw pain and depressive symptoms were related to frailty in the elderly population of China. Path analysis revealed that the relationship between jaw pain and frailty was partially mediated by depression. After adding the covariates, the mediation effect size of depression on the association between jaw pain and frailty was 21.32%. CONCLUSIONS In older adults, jaw pain poses a risk for frailty, and depression mediates between the two. To slow the progression of frailty, attention, and targeted measures are needed for oral health and mental health in older adults.