Deteriorated oral health and function as risk factors for physical disability and mortality in community-dwelling older adults: a systematic review and meta-analysis

PURPOSE: This comprehensive systematic review examined the relationship between oral health and function and the incidence of physical disability and mortality. METHODS: Ovid-MEDLINE, Ovid-EMBASE, and the Cochrane Library were systematically searched, updated February 24th, 2025. Eligible studies included community-dwelling adults aged 50 years or older who underwent oral health-related assessments or interventions and reported outcomes related to physical disability or mortality. Random-effects meta-analysis was used to pool estimates, and subgroup analyses were performed by follow-up duration, study design, and participant age. Risk of bias was assessed using the Risk of Bias for Assessment tool for Nonrandomized Studies version 2.0. tool. RESULTS: Of the 32 articles included, 7 explored the association between oral health or function-related factors and physical disability, 22 investigated mortality outcomes, and 3 examined both outcomes. In total, 441,508 participants were included. Edentulism (OR, 1.73, 95% CI [1.48-2.01], I² = 0%) was significantly associated with physical disability. Regarding mortality, significant risk factors included reduced swallowing function (OR, 2.11, 95% CI [1.88-2.37], I² = 0%), oral frailty (OR, 2.06, 95% CI [1.87-2.27], I² = 0%), fewer than 20 teeth (OR, 2.04, 95% CI [1.67-2.49], I² = 89.7%), edentulism (OR, 1.87, 95% CI [1.35-2.59], I² = 97.0%), and chewing difficulty (OR, 1.77, 95% CI [1.08-2.91], I² = 95.9%). CONCLUSIONS: This systematic review revealed that oral health and function, particularly, masticatory ability and the number of teeth, significantly contributed to physical disability and mortality in older adults.