Current Status and Influencing Factors of Oral Frailty in Hospitalized Elderly Patients with Comorbidities: A Cross-Sectional Study

Current Status and Influencing Factors of Oral Frailty in Hospitalized Elderly Patients with Comorbidities: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Current Status and Influencing Factors of Oral Frailty in Hospitalized Elderly Patients with Comorbidities: A Cross-Sectional Study Xingxing Mi, Yamei Yuan, Ting Wang, Weidong Ye This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8629959/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Investigate the incidence of oral frailty in hospitalized elderly patients with comorbidities and explore its influencing factors. Methods Using a convenience sampling method, 397 elderly inpatients from a tertiary hospital in Hefei, Anhui Province, China, from February 2025 to May 2025 were selected as the survey subjects. Data were collected using a general information questionnaire, Oral Frailty Index-8 (OFI-8), FRAIL scale (FFP), Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression Scale-15 (GDS-15), Modified Barthel Index (MBI), Athens Insomnia Scale (AIS), Oral Health Assessment Tool (OHAT), Eating Assessment Tool-10 (EAT-10), Social Support Rating Scale (SSRS), and Charlson Comorbidity Index (CCI). Participants were divided into the oral frailty group (302 cases) and the non-oral frailty group (85 cases) according to whether oral frailty occurred. Clinical data between the two groups were compared, and binary logistic regression was used to analyze the influencing factors of oral frailty. Results A total of 387 valid questionnaires were collected,with a response rate of 97.48%.The prevalence of oral frailty among hospitalized elderly patients with comorbidities was 78.04%.Binary logistic regression analysis showed that having 10-19 remaining teeth(OR 2.46,95%CI 1.30-4.65, p =0.005)or fewer than 10 remaining teeth(OR 6.10,95%CI 1.69-21.99, p =0.006),being at risk of malnutrition(OR 2.70,95%CI 1.11-3.86, p =0.021),having malnutrition(OR 7.48,95%CI 2.38-23.55, p <0.001),and poor oral health(OR 2.58,95%CI 1.38-4.82, p =0.003)were risk factors for oral frailty in hospitalized elderly patients with comorbidities.Additionally,not having dentures(OR 0.26,95%CI 0.13-0.53, p <0.001),absence of swallowing disorders(OR 0.26,95%CI 0.11-0.64, p =0.003),and a diet mainly consisting of meat(OR 0.39,95%CI 0.18-0.83, p =0.014)were protective factors against oral frailty in this population. Conclusions The incidence of oral frailty is high among hospitalized elderly patients with comorbidities.The number of remaining teeth(<10 or 10~19),malnutrition or risk of malnutrition,and poor oral health are independent risk factors,while having no dentures,no swallowing disorders,and dietary habits(mainly meat-based)are protective factors. Clinical trial number not applicable. Elderly chronic disease comorbidity oral frailty influencing factors 1 Introduction Globally,the number of elderly people continues to grow,and the coexistence of multiple diseases has become a major public health issue [ 1 ] .Comorbidity refers to the presence of two or more chronic diseases in an individual [ 2 ] .In China,25.4%of adults have comorbidities,and the prevalence among elderly people aged 60 and above ranges from 32.4%to 40.2% [ 3 ] .Accordingly,China issued the"Healthy China 2030"Plan,emphasizing the need to strengthen health services for key populations and focus on the health of the elderly [ 4 ] .Oral health,as a'window'reflecting overall health,directly affects the quality of life and disease prognosis of elderly individuals.Oral frailty(OF)refers to age-related decline in oral function,manifested by reduced chewing efficiency,swallowing disorders,tooth loss,and dry mouth,and is associated with older age,alcohol consumption,and physical frailty.A meta-analysis reported that [ 5 ] the overall prevalence of oral frailty is 29.5%;the prevalence among community-dwelling elderly is 31% [ 6 ] ,while among hospitalized patients with chronic diseases,it reaches 61.43% [ 7 ] ,significantly higher than that in the community population,and is positively correlated with polypharmacy and the severity of comorbidities.Currently,research on oral frailty both domestically and internationally focuses on the community and nursing institutions.Although some studies have been conducted on hospitalized patients,they mostly explore the pathogenesis,current status,and treatment of single chronic diseases,and research on oral frailty in the context of comorbidity in the elderly is still insufficient.Therefore,this study investigates the current situation and factors between the two,providing a reference for the development of related nursing measures. 2 Objects and Methods 2.1 Research subject Using a convenience sampling method,a survey was conducted from February to May 2025 on elderly inpatients at a tertiary hospital in Hefei,Anhui Province.Inclusion criteria:①Age ≥ 60 years;②Clear consciousness,no language communication barriers,able to cooperate with the survey;③Informed consent and willingness to participate in this study;④Accompanied by two or more chronic diseases.Exclusion criteria:①Vascular dementia;②Cognitive impairment;③History of psychiatric disorders.The sample size was determined based on the formula for cross-sectional survey studies [ 8 ] ,n=(Z α/2 / P (1- P ))/δ 2 ,where α = 0.05,Z α/2 =1.96, P = 0.78,δ = 0.05,resulting in a calculated sample size of 330.Considering a 20%non-response rate,the minimum final sample size was 396.This study was approved by the Ethics Committee of the Second Affiliated Hospital of Anhui University of Chinese Medicine(Approval No. :2024-zjmc-06),All patients signed the informed consent form. 2.2 Research Methods This study was conducted by distributing and completing questionnaires on-site in a one-on-one manner,with responses recorded in a Q&A format by professionally trained and qualified nursing graduate students.The following measures were followed:(1)Investigators received standardized unified training,providing scientific guidance on asking questions and completing the scales to ensure consistency of results.(2)The questionnaire was designed using simple language to ensure its practicality.(3)After all questions were asked,two members independently reviewed and entered the questionnaires to ensure the authenticity of the data. 2.3 Survey Tools 2.3.1 General Information Questionnaire A structured questionnaire was specifically developed for this study to collect comprehensive data. Its design was based on a review of relevant literature and preliminary survey findings.①Demographic information:gender,age,occupation,smoking,drinking,physical exercise,etc.;②Disease information:number of chronic diseases,types of medications,etc.;③Laboratory examination data:red blood cells,hemoglobin,albumin,prealbumin.The full English version of this questionnaire is available as Supplementary File 1. 2.3.2 The Oral Frailty Index-8(OFI-8) The Oral Frailty Index-8(OFI-8)developed by Tanaka T et al. [ 9 ] can screen individuals at risk of oral frailty and functional impairment.It includes five aspects:denture use,swallowing function,social participation,oral health-related behaviors,and chewing ability,with a total of 8 items and a maximum score of 11.A score of ≥ 4 indicates oral frailty,and higher scores suggest poorer oral health.The scale has a Cronbach'sαcoefficient of 0.692. 2.3.3 Mini Nutritional Assessment-Short Form(MNA-SF) The Mini Nutritional Assessment-Short Form(MNA-SF) [ 10 ] was simplified by Rubenstein LZ et al.in 2001 based on an 18-item scale.The scale includes 6 items:food intake(0–2 points),weight loss(0–3 points),mobility(0–2 points),psychological stress or acute disease(0–2 points),neuropsychological problems(0–2 points),and BMI(0–3 points).The total score ranges from 0 to 14 points:12–14 points indicates normal nutritional status,8–11 points indicates a risk of malnutrition,and 0–7 points indicates malnutrition.The Cronbach'sαcoefficient of this scale is 0.711 [ 11 ] . 2.3.4 FRAIL Frailty Scale(FFP) Frailty assessment was conducted using the FRAIL Frailty Scale(Fried Frailty Phenotype,FFP),which was developed by geriatric experts from the International Society for Nutrition and Aging.The Chinese version was compiled by Wei Y et al. [ 12 ] .This scale includes five items:fatigue,increased resistance or decreased endurance,reduced physical activity,multiple comorbidities,and weight loss.Each item scores 1 point,with a total score of 0 indicating non-frailty,1–2 indicating pre-frailty,and ≥ 3 indicating frailty.The scale has a Cronbach'sαcoefficient of 0.826. 2.3.5 Geriatric Depression Scale–Short Form(GDS-15) Developed by Hoyl and colleagues [ 13 ] ,it is a screening tool for detecting depression in the elderly.The scale(15-item Geriatric Depression Scale,GDS−15)contains 15 items,and respondents answer"yes"or"no."Items 1,5,7,and 11 score 1 point for a"no"answer.The GDS−15 includes 15 questions,each describing the mood and psychological state of older adults over the past week,mainly covering mood,interest,weight,sleep,fatigue,feelings of guilt,suicidal tendencies,and other aspects.Each question has"yes"or"no"response options.The total score ranges from 0 to 15:0–4 points indicate normal,no depressive symptoms;5–8 points indicate mild depressive tendencies or symptoms;9–11 points indicate moderate depressive symptoms;12–15 points indicate severe depressive symptoms.In this study,Cronbach'αcoefficient was 0.77 [ 14 ] . 2.3.6 Oral Health Assessment Tool(OHAT) The Oral Health Assessment Tool(OHAT)was revised by Chalmers and others based on the Brief Oral Health Checklist The Oral Health Assessment Tool(OHAT)was revised by Chalmers and others based on the Brief Oral Health Checklist [ 15 ] .The OHAT scale consists of 8 items.This study used the Chinese version of the scale,with a score of < 3 indicating good oral health,and ≥ 3 indicating poor oral health.The Cronbach'sαcoefficient was0.71 [ 16 ] . 2.3.7 Athens Insomnia Scale(AIS) This scale(Athens Insomnia Scale,AIS)consists of 8 items,each rated on a 4-point scale from 0 to 3,ranging from no problem to severe.A total score of less than 4 indicates no sleep disorder;a total score of 4–6 suggests suspected insomnia;a score above 6 indicates insomnia.The Cronbach'sαcoefficient is 0.89 [ 17 ] . 2.3.8 Eating Assessment Tool-10(EAT-10) The Eating Assessment Tool−10(EAT−10)is a screening tool for swallowing difficulties developed by Belafsky PC et al. [ 18 ] .In 2013,an expert group on dysphagia rehabilitation evaluation and treatment in China conducted a Chinese version [ 19 ] .This study used the Chinese version of the EAT−10 to assess patients'swallowing function.The scale includes 10 items,each scored from 0 to 4,with a total score of 40.A score above 3 on the EAT−10 indicates a possible swallowing disorder.The scale has a Cronbach'sαcoefficient of 0.845. 2.3.9 Charlson Comorbidity Index(CCI) The CCI(Charlson Comorbidity Index)is currently the most commonly used tool for assessing comorbidities.It was developed by Charlson et al. [ 20 ] .The scoring criteria are as follows:2–3 points,low;4–5 points,medium;high ≥ 6 points,three levels. 2.3.10 Social Support Rating Scale(SSRS) This scale(Social Support Rating Scale,SSRS)mainly includes three aspects:objective support,subjective support,and the degree of social support utilization.In the scoring of an individual's social support,low,average,and high scores range from 46 points,respectively.It has good reliability and validity,with a test-retest reliability of 0.92 and item consistency ranging from 0.89 to 0.94. 2.3.11 Modified Barthel Index(MBI) The Modified Barthel Index(MBI) [ 21 ] includes a total of 10 items,each divided into 5 levels:complete dependence,major help,moderate help,minimal help,and complete independence.The score for each level of each item varies,with a total score of 100.A score of ≥ 60 indicates basic self-care ability;41–59 indicates moderate functional impairment;21–40 indicates severe functional impairment;and ≤ 20 indicates complete dependence on external help.The current Cronbach’sαcoefficient is 0.851 [ 22 ] . 2.4 Statistical Methods Data analysis was performed using SPSS 26.0.Measurement data conforming to a normal distribution were described using mean and standard deviation,and comparisons between groups were made using the independent two-sample t-test;measurement data not conforming to a normal distribution were expressed as median and interquartile range,and comparisons between groups were made using the Mann-Whitney U test.Categorical data are presented as frequencies,percentages,or ratios,and comparisons between groups are performed using the chi-square test or rank-sum test.Variables with statistical significance in univariate analysis are included in a binary logistic regression model to identify factors influencing oral frailty in hospitalized elderly patients with comorbidities. 3 Results 3.1 Incidence of Oral Frailty and Its Epidemiological Characteristics in Elderly Hospitalized Patients with Comorbidities A total of 397 questionnaires were distributed in this study.Ten questionnaires with obvious incomplete information were excluded,leaving 387 valid questionnaires collected,with an effective response rate of 97.48%.Among the 387 patients,302 had oral frailty,with an incidence rate of 78.04%.Of these,164 were male(54.30%)and 138 were female(45.70%);106 were aged 60–69(35.10%),122 were aged 70–79(40.40%),and 74 were aged 80 and above(24.5%);69 were unemployed(22.85%),21 were employees(in enterprises or institutions)(6.95%),185 were retired(61.26%),and 27 were farmers(8.94%);184 responded yes(60.93%)and 118 responded no(39.07%).For details,seeTable 1. Table 1 Oral frailty status of hospitalized elderly patients with different characteristics[n(%)] Project Non-OF group( n = 85) OF group( n = 302) Test value p -value Gender χ ²=0.05 0.824 Male 45(52.94) 164(54.30) Female 40(47.06) 138(45.70) Age group χ ²=14.53 < 0.001 60–69 years old 44(51.76) 106(35.10) 70–79 years old 35(41.18) 122(40.40) 80 years old and above 6(7.06) 74(24.50) Profession χ ²=12.48 0.006 Unemployed 10(11.76) 69(22.85) Employee(enterprise,institution,organization) 15(17.65) 21(6.95) Retirement 54(63.53) 185(61.26) Farmer 6(7.06) 27(8.94) Smoking history χ ²=6.98 0.008 No 65(76.47) 184(60.93) Yes 20(23.53) 118(39.07) Drinking history χ ²=2.20 0.138 No 59(69.41) 183(60.60) Yes 26(30.59) 119(39.40) Medical history χ ²=0.22 0.896 1 to 2 types of diseases 15(17.65) 47(15.56) 3 to 5 types of diseases 47(55.29) 170(56.29) > 5 types of diseases 23(27.06) 85(28.15) Types of Medication χ ²=1.23 0.540 0–2 types 15(17.65) 44(14.57) 3 to 5 types 32(37.65) 103(34.11) > 5 types 38(44.71) 155(51.32) History of falls in the past year χ ²=2.88 0.090 Yes 26(30.59) 123(40.73) No 59(69.41) 179(59.27) Chronic pain χ ²=0.00 0.961 Yes 49(57.65) 175(57.95) No 36(42.35) 127(42.05) Physical exercise χ ²=8.16 0.017 Never 27(31.76) 145(48.01) 1–3 times per week 26(30.59) 59(19.54) 4 or more times per week 32(37.65) 98(32.45) BMI χ ²=5.32 0.150 <18.5 kg/m 2 1(1.18) 24(7.95) 18.5kg/m 2 ≤BMI<24kg/m 2 49(57.65) 154(50.99) 24kg/m 2 ≤BMI<28kg/m 2 28(32.94) 97(32.12) ≥ 28 kg/m 2 7(8.24) 27(8.94) Number of remaining teeth χ ²=39.16 < 0.001 20 pieces 59(69.41) 102(33.77) 10 to 19 pieces 23(27.06) 122(40.40) < 10 pieces 3(3.53) 78(25.83) dentures χ ²=22.80 < 0.001 Yes 14(16.47) 136(45.03) No 71(83.53) 166(54.97) Tooth decay χ ²=1.26 0.262 Yes 69(81.18) 260(86.09) No 16(18.82) 42(13.91) Mouth ulcer χ ²=0.15 0.699 Yes 15(17.65) 48(15.89) No 70(82.35) 254(84.11) Dry mouth χ ²=6.51 0.011 Yes 50(58.82) 221(73.18) No 35(41.18) 81(26.82) dietary preferences χ ²=7.02 0.030 Light(in flavor) 52(61.18) 220(72.85) Spicy and greasy 20(23.53) 37(12.25) A bit salty 13(15.29) 45(14.90) Eating habits χ ²=10.57 0.005 Balanced diet of meat and vegetables 25(29.41) 106(35.10) Mainly meat-based 28(32.94) 51(16.89) plant-based 32(37.65) 145(48.01) Chinese Version of the FRAIL Score χ ²=31.24 < 0.001 Not weak 17(20.00) 15(4.97) Early stage of weakness 43(50.59) 113(37.42) Frailty syndrome 25(29.41) 174(57.62) MNA-SF Score χ ²=35.44 < 0.001 Normal 52(61.18) 87(28.81) At risk of malnutrition 29(34.12) 136(45.03) Malnutrition 4(4.71) 79(26.16) GDS-15 Score χ ²=4.85 0.183 Normal 65(76.47) 193(63.91) Mild depression 14(16.47) 71(23.51) Moderate depression 4(4.71) 26(8.61) Severe depression 2(2.35) 12(3.97) ADL Score χ ²=22.99 < 0.001 Able to manage basic daily life independently 66(77.65) 146(48.34) Need to rely on others 19(22.35) 156(51.66) Athens Insomnia Scale(AIS) χ ²=6.70 0.035 Normal sleep 45(52.94) 117(38.74) Suspicious insomnia 27(31.76) 106(35.10) Severe insomnia 13(15.29) 79(26.16) OHAT Assessment χ ²=29.22 < 0.001 Oral health 36(42.35) 46(15.23) Poor oral health 49(57.65) 256(84.77) EAT-10 Score χ ²=31.92 < 0.001 Existing problems 7(8.24) 124(41.06) No problem 78(91.76) 178(58.94) SSRS χ ²=16.85 < 0.001 Low score 11(12.94) 75(24.83) General 35(41.18) 155(51.32) High score 39(45.88) 72(23.84) CCI χ ²=9.03 0.011 Low 12(14.12) 19(6.29) Medium 35(41.18) 101(33.44) High 38(44.71) 182(60.26) Red blood cell 4.22 ± 0.54 4.04 ± 0.65 t = 2.39 0.017 Hemoglobin 126.19 ± 14.10 119.38 ± 20.17 t = 3.55 < 0.001 Prealbumin 259.73 ± 66.68 233.53 ± 81.54 t = 2.72 0.007 Albumin 40.33 ± 3.83 40.49 ± 26.05 t =-0.06 0.955 Note:OF=Oral Frailty,BMI=Body Mass Index,OHAT=Oral Health Assessment Tool,FRAIL=Frailty Scale,MNA-SF=Mini Nutritional Assessment-Short Form,GDS-15 = Geriatric Depression Scale-15,ADL=Modified Barthel Index,AIS=Athens Insomnia Scale,OHAT=Oral Health Assessment Tool,EAT-10 = Eating Assessment Tool-10,SSRS=Social Support Rating Scale,CCI=Charlson Comorbidity Index. 3.2 Univariate Analysis of Oral Frailty in Elderly Patients with Comorbidities Univariate analysis showed that age,occupation,smoking history,physical exercise,number of remaining teeth,use of dentures,presence of dry mouth symptoms,dietary taste,eating habits,FRAIL frailty scale,Mini Nutritional Assessment Short-Form(MNA-SF score),modified Barthel Index(ADL),Athens Insomnia Scale(AIS),oral health assessment tool,Eating Assessment Tool(EAT-10),psychosocial cognition scale,Charlson Comorbidity Index,red blood cells,hemoglobin,and prealbumin were associated with oral frailty in elderly patients with comorbidities,and the differences were statistically significant( P < 0.05).See for Table 1details. 2.3 Binary Logistic Regression Analysis of Factors Affecting Oral Frailty in Elderly Patients with Comorbidities The assignment of independent variables is shown inTable 2.The results of the binary logistic regression analysis are presented inTable 3. Table 2 Methods of Assigning Values to Independent Variables Independent variable Assignment method Age group 1 = 60–69 years old,2 = 70–79 years old,3 = 80 years old and above Profession 1 = Unemployed,2 = Employee(enterprise or institution),3 = Unemployed,4 = Retired Smoking history 1 = No,2 = Yes Physical exercise 1 = Never,2 = 1–3 times per week,3 = 4 or more times per week Number of remaining teeth 1 = 20 pieces,2 = 10–19 pieces,3 = < 10 pieces dentures 1 = Yes,2 = No symptoms of dry mouth 1 = Yes,2 = No dietary preferences 1 = Light,2 = Spicy and greasy,3 = Relatively salty Eating habits 1 = Balanced diet of meat and vegetables,2 = Mainly meat,3 = Mainly vegetarian FRAIL Frailty Scale 1 = Not frail,2 = Pre-frail,3 = Frailty syndrome MNA-SF Score 1 = Normal,2 = At risk of malnutrition,3 = Malnourished Modified Barthel Index(ADL) 1 = Able to take care of daily life independently,2 = Needs to rely on others Athens Insomnia Scale(AIS) 1 = Normal sleep,2 = Suspected insomnia,3 = Severe insomnia Oral Health Assessment Tool 1 = Oral health,2 = Poor oral health Swallowing Difficulty Scale(EAT-10) 1 = Problem exists,2 = No problem Social Psychological Cognition Scale 1 = Low,2 = Medium,3 = High Charlson Comorbidity Index 1 = Low,2 = Medium,3 = High Red blood cell Substitute with actual values Hemoglobin Substitute with actual values Prealbumin Substitute with actual values Note:ADL refers to the ability to perform activities of daily living. Table 3 Binary Logistic Regression Analysis Project β S.E Z P OR(95%CI) Constant 1.90 0.64 2.97 0.003 6.68(1.90 ~ 23.47) Smoking history(using non-smoking as the reference) Yes 0.58 0.34 1.70 0.088 1.79(0.92 ~ 3.49) Number of remaining teeth(based on 20 teeth) 10 to 19 pieces 0.90 0.32 2.78 0.005 2.46(1.30 ~ 4.65) < 10 pieces 1.81 0.65 2.77 0.006 6.10(1.69 ~ 21.99) dentures(using yes as the reference) No -1.34 0.36 -3.72 < 0.001 0.26(0.13 ~ 0.53) Eating habits(based on a balanced diet of meat and vegetables) Mainly meat-based -0.94 0.38 -2.45 0.014 0.39(0.18 ~ 0.83) Primarily vegetarian -0.39 0.35 -1.11 0.267 0.68(0.34 ~ 1.35) MNA-SF Score(with normal nutrition as reference) At risk of malnutrition 0.73 0.32 2.30 0.021 2.70(1.11 ~ 3.86) Malnutrition 2.01 0.59 3.44 < 0.001 7.48(2.38 ~ 23.55) ADL(based on basic self-care abilities) Need to rely on others 0.67 0.35 1.91 0.056 1.96(0.98 ~ 3.89) Oral health assessment tool(based on oral health) Poor oral health 0.95 0.32 2.96 0.003 2.58(1.38 ~ 4.82) EAT-10(with reference to the presence of swallowing difficulties) No problem -1.34 0.46 -2.93 0.003 0.26(0.11 ~ 0.64) Note:OR(Odds Ratio)=odds ratio,CI(Confidence Interval)=confidence interval 4 Discussion 4.1 High Prevalence and Influencing Factors of Oral Frailty in Elderly Patients with Comorbidities ogistic regression analysis revealed that the prevalence of oral frailty in elderly patients with comorbidities was 78.04%,significantly higher than that reported in some previous studies(such as Lv K [ 23 ] and Yin Y [ 24 ] ).This difference may be due to:①heterogeneity of the study population.This study focuses on hospitalized elderly patients with comorbidities,who often have ≥ 2 chronic conditions.Systemic inflammation,polypharmacy,and functional decline may exacerbate oral health deterioration,thereby increasing the risk of oral frailty.②Differences in measurement methods.Yin Y et al. [ 24 ] used the Oral Frailty Index-8(OFI-8)scale and other methods,whereas this study was based on a standardized scale,which may lead to differences in diagnostic rates;Wang XS et al. [ 7 ] studied patients with a single chronic obstructive pulmonary disease(COPD),finding an oral frailty rate of 35.56%,suggesting the impact of cumulative disease effects—patients with comorbidities have multisystem involvement,leading to more pronounced oral function decline [ 25 , 26 ] .③Potential bias in age composition.Zhang JX et al. [ 27 ] reported higher prevalence,with 69.23%of the sample being over 85 years old,while in this study,only 20.67%were over 80.Age,as an independent risk factor for oral frailty,may partially explain the difference. 4.2 Analysis of Factors Affecting Oral Frailty in Elderly Patients with Comorbidities 4.2.1 Tooth Loss Research has found that the fewer the number of teeth,the significantly higher the risk of oral frailty( P < 0.05),which is consistent with previous studies [ 14 ] .The underlying mechanism may be that tooth loss impairs chewing function,hindering thorough chewing and digestion of food,leading to insufficient nutrient intake and absorption,and accelerating muscle atrophy(such as in the tongue and masticatory muscles);missing teeth alter occlusion,further affecting swallowing coordination and nutrient intake;tooth loss can also disturb the balance of oral microbiota,increasing the risk of infection [ 28 ] . 4.2.2 Dentures Not using dentures is a protective factor against oral frailty and can be analyzed from multiple dimensions:①Advantages of natural dentition:Natural teeth form a chain of occlusal force transmission through interproximal contacts,effectively stimulating alveolar bone metabolism to maintain bone density and stability.In contrast,dentures may disrupt these interproximal relationships,leading to imbalanced stress distribution and accelerating local bone resorption [ 29 ] .②Biomechanical defects:Implant-supported fixed dentures lack the periodontal ligament structure.Over time,decreased interproximal strength can lead to food impaction,triggering host immune and inflammatory responses,promoting periodontitis,disturbing bone homeostasis,and further increasing the risk of OF [ 30 , 31 ] .③Adaptive risks:The base stimulation from removable dentures and potential material allergies can easily trigger oral or systemic inflammatory responses.Improper use can cause mechanical injury [ 32 ] ,compounded by changes in salivary flow and drug-induced dry mouth,directly damaging the oral microenvironment.④Nutritional maintenance ability:Natural dentition maintains masticatory efficiency and nutritional intake,indirectly reducing systemic inflammatory load.In contrast,nausea reactions during the adaptation period to dentures limit dietary variety [ 33 ] ,creating a vicious cycle. 4.2.3 Dietary Habits Research shows that a diet primarily consisting of meat is a protective factor against oral frailty(P < 0.05),which is contrary to the findings of Hwang SY et al. [ 34 ] .Elderly patients with comorbidities often have reduced dietary diversity and insufficient caloric intake.Moderate and balanced consumption of meat provides essential nutrients for the body,promotes muscle synthesis,and maintains oral health.Some elderly individuals,due to tooth loss and swallowing difficulties,choose soft,easy-to-chew meat,which can prevent long-term reliance on a nutritionally limited liquid diet.Additionally,protein contributes to the synthesis of immunoglobulins,enhancing oral immunity and reducing the risk of periodontal infections.Therefore,healthcare professionals should encourage hospitalized elderly patients with comorbidities to consume a reasonably high-protein,nutrient-rich diet to compensate for impaired oral functions. 4.2.4 Malnutrition This study indicates that malnutrition or the risk of malnutrition is a risk factor for OF.This is consistent with the findings of Gao J et al. [ 35 ] .The possible mechanisms include decreased bone mass leading to alveolar bone loosening,tooth loss,and reduced oral function [ 36 ] ;deficiencies in trace elements in the body leading to oral inflammation(such as oral ulcers);and insufficient muscle strength,resulting in swallowing difficulties and making it hard for traditional diets to meet the normal functioning of the body,thereby increasing the risk of OF [ 34 ] . 4.2.5 Poor Oral Health Research shows that poor oral health is a risk factor for oral frailty in the elderly,consistent with the findings of Zhao X et al. [ 37 ] .Poor oral health mainly manifests as dental caries,gum recession,and tooth mobility.The prevalence of dental caries among the elderly is 80.97% [ 38 ] .Oral microbial flora causes dental caries through acid production metabolism,acid tolerance,and other pathways.Dental caries leads to reduced saliva secretion,and saliva plays a role in cleaning,buffering,and remineralization.Insufficient saliva secretion diminishes the self-cleaning ability of the oral cavity,causing OF [ 39 ] .Additionally,elderly patients with comorbidities often neglect oral hygiene due to poor daily habits.At the same time,decreased self-care ability and poor adherence to oral health management result in dental problems,such as cavities,not being treated in time.Bacterial infections can then spread to periodontal tissues,causing periodontitis or even tooth mobility;stimulation of the oral mucosa can lead to ulcers and bad breath,increasing the risk of oral frailty. 4.2.6 Swallowing Disorders The results of this study indicate that the absence of swallowing disorders is a protective factor against oral frailty,which is consistent with previous research.Patients with swallowing disorders experience tongue muscle weakness,leading to inadequate chewing and damage to the oral mucosa;delayed pharyngeal reflex causes food to remain,resulting in backward bacterial colonization in the oropharynx and increasing the risk of oral frailty;sarcopenia caused by comorbidities,prolonged nasogastric feeding,or feeding with soft foods leads to disuse atrophy of the oral muscles [ 40 – 42 ] . 5 Conclusions This study shows that the prevalence of oral frailty is relatively high among hospitalized elderly patients with comorbidities.Among the included predictive variables,the number of remaining teeth(< 10 or 10–19),malnutrition,and poor oral health are independent risk factors for oral frailty in this population.Factors such as the absence of dentures,absence of swallowing disorders,and dietary habits(mainly meat-based)serve as protective factors against oral frailty.These findings provide important reference points for the early identification and management of high-risk elderly patients in clinical practice.Healthcare professionals can use this information to focus assessments and interventions on individuals with the aforementioned risk characteristics.However,this study has several limitations.First,the cross-sectional design cannot infer causal relationships.Second,as a single-center study,the representativeness of the sample may be limited,and the generalizability of the findings needs to be validated through future multicenter studies.Third one of the limitations of this study is that the age data were collected as categorical variables, making it impossible to calculate and report precise mean age and standard deviation. Future research could consider collecting continuous age data for more in-depth analysis. Finally,some data rely on patient self-reports,which may be subject to recall bias.Future research should adopt a prospective cohort design to clarify the causal pathways between oral frailty and various influencing factors,and on this basis,develop and test targeted interventions to contribute to the goal of healthy aging. 6 Abbreviations OF Oral frailty OFI-8 The Oral Frailty Index-8 MNA-SF Mini Nutritional Assessment-Short Form FFP FRAIL Frailty Scale OHAT Oral Health Assessment Tool AIS Athens Insomnia Scale EAT-10 Eating Assessment Tool-10 CCI Charlson Comorbidity Index SSRS Social Support Rating Scale MBI Modified Barthel Index COPD chronic obstructive pulmonary disease Declarations Acknowledgments We are grateful to all the participants who took part in this study. Author Contributions Xingxing Mi:Made substantial contributions to the study design and methodology,performed the formal analysis and investigation,curated the data,wrote the original draft,and contributed to the review and editing of the manuscript. Ya-Mei Yuan:The lead investigator and guarantor of the study.Conceived and designed the study,acquired funding,supervised the project,and contributed to the writing and critical review of the manuscript. Ting Wang:Contributed to the methodology and participated in the critical review and editing of the manuscript. Weidong Ye:Contributed to the acquisition of funding for the project. All authors have read and approved the manuscript. Funding This study was supported by High-Level Talent Support Program of Anhui University of Chinese Medicine(Grant No.2024rcyb021),National Natural Science Foundation of China(NSFC)Youth Project(Grant No.82305187),and2024 Application Transformation of Traditional Chinese Medicine in Preventing and Treating Major Pulmonary Diseases,Anhui Provincial Key Laboratory Project(Grant No.2024ZYFBAHKLA09). Data availability The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request. Ethics approval and consent to participate This study was conducted in accordance with the ethical principles of the Declaration of Helsinki and this study involves human participants and was approved by the Ethics Committee of the Second Affiliated Hospital of Anhui University of Chinese Medicine(Approval No.:2024-zjmc-06).Participants gave informed consent to participate in the study before taking part. Consent for publication Not applicable Conflict of Interest The author of this work is not required to disclose any. References Huang ZJ. Mai ZH,Wang HX,et al.Study on the Current Situation and Influencing Factors of Comorbidity of the'Three Highs'in the Elderly and Family Function. Chin Gen Pract. 2025;28(16):2001–10. Zhao Y, Atun R, Oldenburg B, et al. Physical multimorbidity,health service use,and catastrophic health expenditure by socioeconomic groups in China:an analysis of population-based panel data. Lancet Glob Health. 2020;8(6):e840–9. Hu Y, Wang Z, He H, et al. Prevalence and patterns of multimorbidity in China during 2002–2022:A systematic review and meta-analysis. Ageing Res Rev. 2024;93:102165. Zhuang XY. The Concept of People's Health in the New Era from the Perspective of Chinese-Style Modernization. Hunan Social Sci 2025;(02):105–15. Qiao WW, Tian HP, Guo J, et al. Meta-analysis of the prevalence of oral frailty in the elderly. Chin Gen Pract. 2024;27(30):3810–6. Xiong Y, Guo MJ, Tao SL, et al. Systematic Review and Meta-Analysis of the Prevalence of Oral Frailty in Community-Dwelling Older Adults. Mod Prev Med. 2024;51(23):4405–10. Wang XS, Ye LX,Chen L, et al. Analysis of the Current Status and Influencing Factors of Oral Frailty in Hospitalized Patients with Chronic Diseases. J Chronic Dis. 2025;26(01):23–7. Pourhoseingholi MA. Vahedi M,Rahimzadeh M.Sample size calculation in medical studies. Gastroenterol Hepatol Bed BenchWinter. 2013;6(1):14–7. Tanaka T, Hirano H, Ohara Y, et al. Oral Frailty Index-8 in the risk assessment of new-onset oral frailty and functional disability among community-dwelling older adults. Arch Gerontol Geriatr. 2021;94:104340. Rubenstein LZ. Harker JO,SalvàA,et al.Screening for undernutrition in geriatric practice:developing the short-form mini-nutritional assessment(MNA-SF).J Gerontol A Biol. Sci Med Sci Jun. 2001;56(6):M366–72. Zhang Y, Wang LX,Lu XH, et al. Application of the Mini Nutritional Assessment Short-Form in Nutritional Screening of Elderly Hospitalized Patients with Chronic Diseases. Chin J Geriatric Multi-Organ Dis. 2019;18(02):107–11. Kugimiya Y, Motokawa K, Yamamoto K, et al. [Relationship between the rate of a decreased oral function and the nutrient intake in community-dwelling older persons:An examination using oral function-related items in a questionnaire for latter-stage elderly people]. Nihon Ronen Igakkai Zasshi. 2021;58(1):91–100. Hoyl MT Alessi, Harker CA. Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc. 1999;47(7):873–8. Luo W, Zhou J, Qiu L, et al. Influencing factors of oral frailty in elderly patients with type 2 diabetes in China:a cross-sectional study based on the integral model of frailty. BMC Oral Health. 2025;25(1):546. Chalmers JM, King PL,Spencer AJ, et al. The oral health assessment tool–validity and reliability. Aust Dent J. 2005;50(3):191–9. Wang JQ, Zhu SZ, Zhan, et al. Localization and Reliability and Validity Testing of the Oral Health Assessment Scale. Chin J Mod Nurs. 2019;25(28):3607–10. Soldatos CR. Dikeos DG,Paparrigopoulos TJ.Athens Insomnia Scale:validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000;48(6):555–60. Belafsky PC Mouadeb, Rees DA. Validity and reliability of the Eating Assessment Tool(EAT-10). Ann Otol Rhinol Laryngol Dec. 2008;117(12):919–24. Expert Group on the Assessment and Treatment of Dysphagia Rehabilitation in China. Expert Consensus on the Assessment and Treatment of Dysphagia Rehabilitation in China(2013 Edition). Chin J Phys Med Rehabilitation. 2013;35(12):916–29. Charlson ME. Pompei P,Ales KL,et al.A new method of classifying prognostic comorbidity in longitudinal studies:development and validation. J Chronic Dis. 1987;40(5):373–83. Leung SO. Chan CC,Shah S.Development of a Chinese version of the Modified Barthel Index–validity and reliability. Clin Rehabil. 2007;21(10):912–22. Li XYJ, Wu XY, et al. Study on the Reliability and Validity of the Modified Barthel Index(MBI)in Assessing Activities of Daily Living(ADL)After Upper Limb Amputation and Replantation. J Practical Hand Surg. 2021;35(03):379–81. Lv K, Yu P, Xue Y, et al. A pathway analysis of the role of factors influencing oral frailty in community-dwelling older adults:structural equation modeling. Geriatr Nurs. 2025;63:428–33. Yin Y, Zhao Y, Fei Y, et al. Epidemiology and risk factors of oral frailty among older people:an observational study from China. BMC Oral Health. 2024;24(1):368. Lin Y, Wang F, Wang H, et al. Meta-analysis of frailty prevalence in elderly patients with comorbidities. Chin Gen Pract. 2023;26(25):3185–93. Guo ZX, Xu HP, Zhang Y, et al. Study on the comorbidity status and influencing factors of oral frailty and sarcopenia in hospitalized elderly patients. Chin J Nurs. 2025;60(03):281–7. Zhang JX, Yang AP, Li X, et al. Study on the Current Status and Influencing Factors of Oral Frailty among the Elderly in Elder Care Institutions. J Nurs Adm Manag. 2025;25(02):171–4. Ge WY, Li R, Zhang Y, et al. Analysis of the potential profile and influencing factors for oral frailty in olderly patients with dental implants. BMC Oral Health. 2024;24(1):1079. He C, Wang Y, Qin C, et al. Association between tooth loss and geriatric syndromes in older adults:a cohort study from a rural area in eastern China. Aging Clin Exp Res. 2025;37(1):128. Chanthasan S. Mattheos N,Pisarnturakit PP,et al.Subbalekha K.Influence of interproximal peri-implant tissue and prosthesis contours on food impaction,tissue health and patients'quality of life. Clin Oral Implants Res. 2022;33(7):768–81. Insua A, Galindo-Moreno P, Miron RJ et al. Emerging factors affecting peri-implant bone metabolism.Periodontol 2000 2024;94(1):27–78. Alzoubi NS, Kuraitby S. Almustafa A.Investigation of traumatic ulcer locations and healing progression during denture adjustment periods in Syrian complete denture patients. Sci Rep. 2025;15(1):23890. Gomez GGF, Xu H, Spence LA, et al. Assessing the nutrient intake and diet quality of adults wearing dentures using the healthy eating index. BMC Oral Health. 2025;25(1):996. Hwang SY. Jang JH,Park JE.Association between Healthy Lifestyle(Diet Quality,Physical Activity,Normal Body Weight)and Periodontal Diseases in Korean Adults. Int J Environ Res Public Health 2022;19(7). Gao J, Fu Y, Wang Y, et al. Association of oral health with nutritional status of the older adults:a cross-sectional study. Eur J Nutr. 2024;64(1):2. Viñas P, Martín-Martínez A, Cera M, et al. Characteristics and Therapeutic Needs of Older Patients with Oropharyngeal Dysphagia Admitted to a General Hospital. J Nutr Health Aging. 2023;27(11):996–1004. Zhao X, Chen HM, Xing. YT,et al.A study on the correlation between oral health literacy,oral health status,and oral health self-efficacy in the elderly. Chin Med Herald. 2025;22(02):102–7. Jian LX. He WZ,Wu JX,et alAnalysis of the Current Status and Influencing Factors of Caries Treatment in 226 Elderly People in Chengdu. Chin J Geriatric Dentistry. 2023;21(01):19–23. Masutomi K, Bando M, Inagaki Y, et al. Relationship between oral hypofunction and salivary biomarkers in older adults:a cross-sectional study. BMC Oral Health. 2024;24(1):766. Chen L, Gu L, Li. X,et alOral health matters in cognitive impaired aged residents in geriatric care facilities:A cross-sectional survey. Nurs Open. 2021;8(2):792–8. Wang L, Ju M, Wang T, et al. Analysis of the Current Status and Influencing Factors of Oral Frailty Risk in the Elderly in the Community. J Nurs. 2023;38(18):112–6. Yang T. Sun ML,Duan XY.The effect of oral neuromuscular training on the rehabilitation of swallowing dysfunction in frail elderly patients in the community. Chin Rehabilitation. 2022;37(04):214–8. Additional Declarations No competing interests reported. Supplementary Files SupplementaryFile1Questionnaire.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8629959","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":629865394,"identity":"d84060f7-b4ab-4282-81f0-87a2dfbf81f3","order_by":0,"name":"Xingxing Mi","email":"","orcid":"","institution":"Anhui University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Xingxing","middleName":"","lastName":"Mi","suffix":""},{"id":629865400,"identity":"f3cc68a0-2d04-4c58-ac52-1f38d0e85b7f","order_by":1,"name":"Yamei Yuan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAArUlEQVRIiWNgGAWjYBADOQZm0jQkMBiTriWxgWjFBjeyEz/8/LEtfX4778EPDDU20URoyd0s2ZNwO3fDYb5kCYZjabkErQNq2SDNANLCzGMgwdhwmCgtm38DtaTLN/MY/yBWyzaQLQkMh3nMiLNF8szbbZY9abcNNwC1WCQQ4xe+47mbb/ywuS0v33/G+MaHGhvCWhQuJCDxEnCoQgHy/QeIUTYKRsEoGAUjGgAAH3hBwsMSBHsAAAAASUVORK5CYII=","orcid":"","institution":"Anhui University of Chinese Medicine","correspondingAuthor":true,"prefix":"","firstName":"Yamei","middleName":"","lastName":"Yuan","suffix":""},{"id":629865401,"identity":"b573f40e-34b6-47e1-953a-c1dc74c34d6e","order_by":2,"name":"Ting Wang","email":"","orcid":"","institution":"Second Affiliated Hospital of Anhui University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Ting","middleName":"","lastName":"Wang","suffix":""},{"id":629865402,"identity":"9071c30c-f792-4b06-a8ea-2c07766c5681","order_by":3,"name":"Weidong Ye","email":"","orcid":"","institution":"Anhui University of Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Weidong","middleName":"","lastName":"Ye","suffix":""}],"badges":[],"createdAt":"2026-01-18 08:08:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8629959/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8629959/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":109297858,"identity":"8e6f23cf-d8c0-4d6a-a9b1-8b4817370ddb","added_by":"auto","created_at":"2026-05-15 09:06:56","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":513030,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8629959/v1/19a3531a-ae9c-4b19-8819-21329b6c989a.pdf"},{"id":108003096,"identity":"5412cbfc-7d83-4031-950d-0a7f237c9420","added_by":"auto","created_at":"2026-04-28 12:23:07","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":54733,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryFile1Questionnaire.docx","url":"https://assets-eu.researchsquare.com/files/rs-8629959/v1/f1849afba4463bf4a44454fc.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eCurrent Status and Influencing Factors of Oral Frailty in Hospitalized Elderly Patients with Comorbidities: A Cross-Sectional Study\u003c/p\u003e","fulltext":[{"header":"1 Introduction","content":"\u003cp\u003eGlobally,the number of elderly people continues to grow,and the coexistence of multiple diseases has become a major public health issue\u003csup\u003e[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/sup\u003e.Comorbidity refers to the presence of two or more chronic diseases in an individual\u003csup\u003e[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/sup\u003e.In China,25.4%of adults have comorbidities,and the prevalence among elderly people aged 60 and above ranges from 32.4%to 40.2%\u003csup\u003e[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/sup\u003e.Accordingly,China issued the\"Healthy China 2030\"Plan,emphasizing the need to strengthen health services for key populations and focus on the health of the elderly\u003csup\u003e[\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]\u003c/sup\u003e.Oral health,as a'window'reflecting overall health,directly affects the quality of life and disease prognosis of elderly individuals.Oral frailty(OF)refers to age-related decline in oral function,manifested by reduced chewing efficiency,swallowing disorders,tooth loss,and dry mouth,and is associated with older age,alcohol consumption,and physical frailty.A meta-analysis reported that\u003csup\u003e[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/sup\u003ethe overall prevalence of oral frailty is 29.5%;the prevalence among community-dwelling elderly is 31%\u003csup\u003e[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/sup\u003e,while among hospitalized patients with chronic diseases,it reaches 61.43%\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003e,significantly higher than that in the community population,and is positively correlated with polypharmacy and the severity of comorbidities.Currently,research on oral frailty both domestically and internationally focuses on the community and nursing institutions.Although some studies have been conducted on hospitalized patients,they mostly explore the pathogenesis,current status,and treatment of single chronic diseases,and research on oral frailty in the context of comorbidity in the elderly is still insufficient.Therefore,this study investigates the current situation and factors between the two,providing a reference for the development of related nursing measures.\u003c/p\u003e"},{"header":"2 Objects and Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e2.1 Research subject\u003c/h2\u003e \u003cp\u003eUsing a convenience sampling method,a survey was conducted from February to May 2025 on elderly inpatients at a tertiary hospital in Hefei,Anhui Province.Inclusion criteria:①Age\u0026thinsp;\u0026ge;\u0026thinsp;60 years;②Clear consciousness,no language communication barriers,able to cooperate with the survey;③Informed consent and willingness to participate in this study;④Accompanied by two or more chronic diseases.Exclusion criteria:①Vascular dementia;②Cognitive impairment;③History of psychiatric disorders.The sample size was determined based on the formula for cross-sectional survey studies\u003csup\u003e[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/sup\u003e,n=(Z\u003csub\u003eα/2\u003c/sub\u003e/\u003cem\u003eP\u003c/em\u003e(1-\u003cem\u003eP\u003c/em\u003e))/δ\u003csup\u003e2\u003c/sup\u003e,where α\u0026thinsp;=\u0026thinsp;0.05,Z\u003csub\u003eα/2\u003c/sub\u003e=1.96,\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.78,δ\u0026thinsp;=\u0026thinsp;0.05,resulting in a calculated sample size of 330.Considering a 20%non-response rate,the minimum final sample size was 396.This study was approved by the Ethics Committee of the Second Affiliated Hospital of Anhui University of Chinese Medicine(Approval No. :2024-zjmc-06),All patients signed the informed consent form.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e2.2 Research Methods\u003c/h2\u003e \u003cp\u003eThis study was conducted by distributing and completing questionnaires on-site in a one-on-one manner,with responses recorded in a Q\u0026amp;A format by professionally trained and qualified nursing graduate students.The following measures were followed:(1)Investigators received standardized unified training,providing scientific guidance on asking questions and completing the scales to ensure consistency of results.(2)The questionnaire was designed using simple language to ensure its practicality.(3)After all questions were asked,two members independently reviewed and entered the questionnaires to ensure the authenticity of the data.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e2.3 Survey Tools\u003c/h2\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003e2.3.1 General Information Questionnaire\u003c/h2\u003e \u003cp\u003eA structured questionnaire was specifically developed for this study to collect comprehensive data. Its design was based on a review of relevant literature and preliminary survey findings.①Demographic information:gender,age,occupation,smoking,drinking,physical exercise,etc.;②Disease information:number of chronic diseases,types of medications,etc.;③Laboratory examination data:red blood cells,hemoglobin,albumin,prealbumin.The full English version of this questionnaire is available as Supplementary File 1.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003e2.3.2 The Oral Frailty Index-8(OFI-8)\u003c/h2\u003e \u003cp\u003e The Oral Frailty Index-8(OFI-8)developed by Tanaka T et al.\u003csup\u003e[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/sup\u003ecan screen individuals at risk of oral frailty and functional impairment.It includes five aspects:denture use,swallowing function,social participation,oral health-related behaviors,and chewing ability,with a total of 8 items and a maximum score of 11.A score of \u0026ge;\u0026thinsp;4 indicates oral frailty,and higher scores suggest poorer oral health.The scale has a Cronbach'sαcoefficient of 0.692.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section3\"\u003e \u003ch2\u003e2.3.3 Mini Nutritional Assessment-Short Form(MNA-SF)\u003c/h2\u003e \u003cp\u003eThe Mini Nutritional Assessment-Short Form(MNA-SF)\u003csup\u003e[\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]\u003c/sup\u003ewas simplified by Rubenstein LZ et al.in 2001 based on an 18-item scale.The scale includes 6 items:food intake(0\u0026ndash;2 points),weight loss(0\u0026ndash;3 points),mobility(0\u0026ndash;2 points),psychological stress or acute disease(0\u0026ndash;2 points),neuropsychological problems(0\u0026ndash;2 points),and BMI(0\u0026ndash;3 points).The total score ranges from 0 to 14 points:12\u0026ndash;14 points indicates normal nutritional status,8\u0026ndash;11 points indicates a risk of malnutrition,and 0\u0026ndash;7 points indicates malnutrition.The Cronbach'sαcoefficient of this scale is 0.711\u003csup\u003e[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003e2.3.4 FRAIL Frailty Scale(FFP)\u003c/h2\u003e \u003cp\u003eFrailty assessment was conducted using the FRAIL Frailty Scale(Fried Frailty Phenotype,FFP),which was developed by geriatric experts from the International Society for Nutrition and Aging.The Chinese version was compiled by Wei Y et al.\u003csup\u003e[\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]\u003c/sup\u003e.This scale includes five items:fatigue,increased resistance or decreased endurance,reduced physical activity,multiple comorbidities,and weight loss.Each item scores 1 point,with a total score of 0 indicating non-frailty,1\u0026ndash;2 indicating pre-frailty,and \u0026ge;\u0026thinsp;3 indicating frailty.The scale has a Cronbach'sαcoefficient of 0.826.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section3\"\u003e \u003ch2\u003e2.3.5 Geriatric Depression Scale\u0026ndash;Short Form(GDS-15)\u003c/h2\u003e \u003cp\u003eDeveloped by Hoyl and colleagues\u003csup\u003e[\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]\u003c/sup\u003e,it is a screening tool for detecting depression in the elderly.The scale(15-item Geriatric Depression Scale,GDS\u0026minus;15)contains 15 items,and respondents answer\"yes\"or\"no.\"Items 1,5,7,and 11 score 1 point for a\"no\"answer.The GDS\u0026minus;15 includes 15 questions,each describing the mood and psychological state of older adults over the past week,mainly covering mood,interest,weight,sleep,fatigue,feelings of guilt,suicidal tendencies,and other aspects.Each question has\"yes\"or\"no\"response options.The total score ranges from 0 to 15:0\u0026ndash;4 points indicate normal,no depressive symptoms;5\u0026ndash;8 points indicate mild depressive tendencies or symptoms;9\u0026ndash;11 points indicate moderate depressive symptoms;12\u0026ndash;15 points indicate severe depressive symptoms.In this study,Cronbach'αcoefficient was 0.77\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section3\"\u003e \u003ch2\u003e2.3.6 Oral Health Assessment Tool(OHAT)\u003c/h2\u003e \u003cp\u003eThe Oral Health Assessment Tool(OHAT)was revised by Chalmers and others based on the Brief Oral Health Checklist The Oral Health Assessment Tool(OHAT)was revised by Chalmers and others based on the Brief Oral Health Checklist\u003csup\u003e[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/sup\u003e.The OHAT scale consists of 8 items.This study used the Chinese version of the scale,with a score of \u0026lt;\u0026thinsp;3 indicating good oral health,and \u0026ge;\u0026thinsp;3 indicating poor oral health.The Cronbach'sαcoefficient was0.71\u003csup\u003e[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section3\"\u003e \u003ch2\u003e2.3.7 Athens Insomnia Scale(AIS)\u003c/h2\u003e \u003cp\u003eThis scale(Athens Insomnia Scale,AIS)consists of 8 items,each rated on a 4-point scale from 0 to 3,ranging from no problem to severe.A total score of less than 4 indicates no sleep disorder;a total score of 4\u0026ndash;6 suggests suspected insomnia;a score above 6 indicates insomnia.The Cronbach'sαcoefficient is 0.89\u003csup\u003e[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section3\"\u003e \u003ch2\u003e2.3.8 Eating Assessment Tool-10(EAT-10)\u003c/h2\u003e \u003cp\u003eThe Eating Assessment Tool\u0026minus;10(EAT\u0026minus;10)is a screening tool for swallowing difficulties developed by Belafsky PC et al.\u003csup\u003e[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/sup\u003e.In 2013,an expert group on dysphagia rehabilitation evaluation and treatment in China conducted a Chinese version\u003csup\u003e[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/sup\u003e.This study used the Chinese version of the EAT\u0026minus;10 to assess patients'swallowing function.The scale includes 10 items,each scored from 0 to 4,with a total score of 40.A score above 3 on the EAT\u0026minus;10 indicates a possible swallowing disorder.The scale has a Cronbach'sαcoefficient of 0.845.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section3\"\u003e \u003ch2\u003e2.3.9 Charlson Comorbidity Index(CCI)\u003c/h2\u003e \u003cp\u003eThe CCI(Charlson Comorbidity Index)is currently the most commonly used tool for assessing comorbidities.It was developed by Charlson et al.\u003csup\u003e[\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/sup\u003e.The scoring criteria are as follows:2\u0026ndash;3 points,low;4\u0026ndash;5 points,medium;high\u0026thinsp;\u0026ge;\u0026thinsp;6 points,three levels.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section3\"\u003e \u003ch2\u003e2.3.10 Social Support Rating Scale(SSRS)\u003c/h2\u003e \u003cp\u003eThis scale(Social Support Rating Scale,SSRS)mainly includes three aspects:objective support,subjective support,and the degree of social support utilization.In the scoring of an individual's social support,low,average,and high scores range from \u0026lt;\u0026thinsp;33,33\u0026ndash;45,and \u0026gt;\u0026thinsp;46 points,respectively.It has good reliability and validity,with a test-retest reliability of 0.92 and item consistency ranging from 0.89 to 0.94.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section3\"\u003e \u003ch2\u003e2.3.11 Modified Barthel Index(MBI)\u003c/h2\u003e \u003cp\u003eThe Modified Barthel Index(MBI)\u003csup\u003e[\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/sup\u003eincludes a total of 10 items,each divided into 5 levels:complete dependence,major help,moderate help,minimal help,and complete independence.The score for each level of each item varies,with a total score of 100.A score of \u0026ge;\u0026thinsp;60 indicates basic self-care ability;41\u0026ndash;59 indicates moderate functional impairment;21\u0026ndash;40 indicates severe functional impairment;and \u0026le;\u0026thinsp;20 indicates complete dependence on external help.The current Cronbach\u0026rsquo;sαcoefficient is 0.851\u003csup\u003e[\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003e2.4 Statistical Methods\u003c/h2\u003e \u003cp\u003e Data analysis was performed using SPSS 26.0.Measurement data conforming to a normal distribution were described using mean and standard deviation,and comparisons between groups were made using the independent two-sample t-test;measurement data not conforming to a normal distribution were expressed as median and interquartile range,and comparisons between groups were made using the Mann-Whitney U test.Categorical data are presented as frequencies,percentages,or ratios,and comparisons between groups are performed using the chi-square test or rank-sum test.Variables with statistical significance in univariate analysis are included in a binary logistic regression model to identify factors influencing oral frailty in hospitalized elderly patients with comorbidities.\u003c/p\u003e \u003c/div\u003e"},{"header":"3 Results","content":"\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Incidence of Oral Frailty and Its Epidemiological Characteristics in Elderly Hospitalized Patients with Comorbidities\u003c/h2\u003e \u003cp\u003eA total of 397 questionnaires were distributed in this study.Ten questionnaires with obvious incomplete information were excluded,leaving 387 valid questionnaires collected,with an effective response rate of 97.48%.Among the 387 patients,302 had oral frailty,with an incidence rate of 78.04%.Of these,164 were male(54.30%)and 138 were female(45.70%);106 were aged 60\u0026ndash;69(35.10%),122 were aged 70\u0026ndash;79(40.40%),and 74 were aged 80 and above(24.5%);69 were unemployed(22.85%),21 were employees(in enterprises or institutions)(6.95%),185 were retired(61.26%),and 27 were farmers(8.94%);184 responded yes(60.93%)and 118 responded no(39.07%).For details,seeTable 1.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eOral frailty status of hospitalized elderly patients with different characteristics[n(%)]\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003eNon-OF group(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;85)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOF group(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;302)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eTest value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cem\u003ep\u003c/em\u003e-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=0.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.824\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e45(52.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e164(54.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e40(47.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e138(45.70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=14.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e60\u0026ndash;69 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e44(51.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e106(35.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e70\u0026ndash;79 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e35(41.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e122(40.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e80 years old and above\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e6(7.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e74(24.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=12.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eUnemployed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e10(11.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69(22.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eEmployee(enterprise,institution,organization)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e15(17.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21(6.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eRetirement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e54(63.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e185(61.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFarmer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e6(7.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27(8.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSmoking history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=6.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e65(76.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e184(60.93)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c5\" namest=\"c3\"\u003e \u003cp\u003e20(23.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e118(39.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=2.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.138\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e59(69.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e183(60.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e26(30.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e119(39.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=0.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.896\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1 to 2 types of diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e15(17.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e47(15.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 to 5 types of diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e47(55.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e170(56.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 types of diseases\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e23(27.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e85(28.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTypes of Medication\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.540\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;2 types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e15(17.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e44(14.57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3 to 5 types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e32(37.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e103(34.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5 types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e38(44.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e155(51.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHistory of falls in the past year\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=2.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.090\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e26(30.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e123(40.73)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e59(69.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e179(59.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=0.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.961\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(57.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e175(57.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e36(42.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e127(42.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical exercise\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=8.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e27(31.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e145(48.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u0026ndash;3 times per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e26(30.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e59(19.54)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4 or more times per week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e32(37.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e98(32.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBMI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=5.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.150\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;18.5 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e1(1.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e24(7.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e18.5kg/m\u003csup\u003e2\u003c/sup\u003e\u0026le;BMI\u0026lt;24kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e49(57.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e154(50.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e24kg/m\u003csup\u003e2\u003c/sup\u003e\u0026le;BMI\u0026lt;28kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e28(32.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e97(32.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;28 kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e7(8.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e27(8.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of remaining teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=39.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e20 pieces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e59(69.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e102(33.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10 to 19 pieces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e23(27.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e122(40.40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 pieces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e3(3.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e78(25.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edentures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=22.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e14(16.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e136(45.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e71(83.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e166(54.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTooth decay\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.262\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e69(81.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e260(86.09)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e16(18.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c6\" namest=\"c4\"\u003e \u003cp\u003e42(13.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMouth ulcer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=0.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.699\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e15(17.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e48(15.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e70(82.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e254(84.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDry mouth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=6.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e50(58.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e221(73.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e35(41.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e81(26.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edietary preferences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=7.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.030\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLight(in flavor)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e52(61.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e220(72.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpicy and greasy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e20(23.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e37(12.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA bit salty\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e13(15.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e45(14.90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEating habits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=10.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBalanced diet of meat and vegetables\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e25(29.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e106(35.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMainly meat-based\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e28(32.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e51(16.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eplant-based\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e32(37.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e145(48.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChinese Version of the FRAIL Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=31.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNot weak\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e17(20.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e15(4.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEarly stage of weakness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e43(50.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e113(37.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFrailty syndrome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e25(29.41)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e174(57.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMNA-SF Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=35.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e52(61.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e87(28.81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt risk of malnutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e29(34.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e136(45.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalnutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e4(4.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e79(26.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGDS-15 Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=4.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.183\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e65(76.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e193(63.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMild depression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e14(16.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e71(23.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModerate depression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e4(4.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e26(8.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere depression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e2(2.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e12(3.97)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADL Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=22.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAble to manage basic daily life independently\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e66(77.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e146(48.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeed to rely on others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e19(22.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e156(51.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAthens Insomnia Scale(AIS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=6.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.035\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNormal sleep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e45(52.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e117(38.74)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuspicious insomnia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e27(31.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e106(35.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSevere insomnia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e13(15.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e79(26.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOHAT Assessment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=29.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e36(42.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e46(15.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor oral health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e49(57.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e256(84.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEAT-10 Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=31.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eExisting problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e7(8.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e124(41.06)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e78(91.76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e178(58.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSSRS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=16.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e11(12.94)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e75(24.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGeneral\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e35(41.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e155(51.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e39(45.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e72(23.84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCCI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eχ\u003c/em\u003e\u0026sup2;=9.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e12(14.12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e19(6.29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedium\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e35(41.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e101(33.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e38(44.71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e182(60.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRed blood cell\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e4.22\u0026thinsp;\u0026plusmn;\u0026thinsp;0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e4.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.017\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemoglobin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e126.19\u0026thinsp;\u0026plusmn;\u0026thinsp;14.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e119.38\u0026thinsp;\u0026plusmn;\u0026thinsp;20.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u0026thinsp;=\u0026thinsp;3.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrealbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e259.73\u0026thinsp;\u0026plusmn;\u0026thinsp;66.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e233.53\u0026thinsp;\u0026plusmn;\u0026thinsp;81.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003e40.33\u0026thinsp;\u0026plusmn;\u0026thinsp;3.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e40.49\u0026thinsp;\u0026plusmn;\u0026thinsp;26.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003et\u003c/em\u003e=-0.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.955\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003eNote:OF=Oral Frailty,BMI=Body Mass Index,OHAT=Oral Health Assessment Tool,FRAIL=Frailty Scale,MNA-SF=Mini Nutritional Assessment-Short Form,GDS-15\u0026thinsp;=\u0026thinsp;Geriatric Depression Scale-15,ADL=Modified Barthel Index,AIS=Athens Insomnia Scale,OHAT=Oral Health Assessment Tool,EAT-10\u0026thinsp;=\u0026thinsp;Eating Assessment Tool-10,SSRS=Social Support Rating Scale,CCI=Charlson Comorbidity Index.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Univariate Analysis of Oral Frailty in Elderly Patients with Comorbidities\u003c/h2\u003e \u003cp\u003eUnivariate analysis showed that age,occupation,smoking history,physical exercise,number of remaining teeth,use of dentures,presence of dry mouth symptoms,dietary taste,eating habits,FRAIL frailty scale,Mini Nutritional Assessment Short-Form(MNA-SF score),modified Barthel Index(ADL),Athens Insomnia Scale(AIS),oral health assessment tool,Eating Assessment Tool(EAT-10),psychosocial cognition scale,Charlson Comorbidity Index,red blood cells,hemoglobin,and prealbumin were associated with oral frailty in elderly patients with comorbidities,and the differences were statistically significant(\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05).See for Table\u0026nbsp;1details.\u003c/p\u003e \u003cp\u003e \u003cb\u003e2.3 Binary Logistic Regression Analysis of Factors Affecting Oral Frailty in Elderly Patients with Comorbidities\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThe assignment of independent variables is shown inTable 2.The results of the binary logistic regression analysis are presented inTable 3.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMethods of Assigning Values to Independent Variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIndependent variable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAssignment method\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;60\u0026ndash;69 years old,2\u0026thinsp;=\u0026thinsp;70\u0026ndash;79 years old,3\u0026thinsp;=\u0026thinsp;80 years old and above\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProfession\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Unemployed,2\u0026thinsp;=\u0026thinsp;Employee(enterprise or institution),3\u0026thinsp;=\u0026thinsp;Unemployed,4\u0026thinsp;=\u0026thinsp;Retired\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking history\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;No,2\u0026thinsp;=\u0026thinsp;Yes\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical exercise\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Never,2\u0026thinsp;=\u0026thinsp;1\u0026ndash;3 times per week,3\u0026thinsp;=\u0026thinsp;4 or more times per week\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of remaining teeth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;20 pieces,2\u0026thinsp;=\u0026thinsp;10\u0026ndash;19 pieces,3\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;10 pieces\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edentures\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Yes,2\u0026thinsp;=\u0026thinsp;No\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003esymptoms of dry mouth\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Yes,2\u0026thinsp;=\u0026thinsp;No\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edietary preferences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Light,2\u0026thinsp;=\u0026thinsp;Spicy and greasy,3\u0026thinsp;=\u0026thinsp;Relatively salty\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEating habits\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Balanced diet of meat and vegetables,2\u0026thinsp;=\u0026thinsp;Mainly meat,3\u0026thinsp;=\u0026thinsp;Mainly vegetarian\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFRAIL Frailty Scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Not frail,2\u0026thinsp;=\u0026thinsp;Pre-frail,3\u0026thinsp;=\u0026thinsp;Frailty syndrome\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMNA-SF Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Normal,2\u0026thinsp;=\u0026thinsp;At risk of malnutrition,3\u0026thinsp;=\u0026thinsp;Malnourished\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eModified Barthel Index(ADL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Able to take care of daily life independently,2\u0026thinsp;=\u0026thinsp;Needs to rely on others\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAthens Insomnia Scale(AIS)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Normal sleep,2\u0026thinsp;=\u0026thinsp;Suspected insomnia,3\u0026thinsp;=\u0026thinsp;Severe insomnia\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral Health Assessment Tool\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Oral health,2\u0026thinsp;=\u0026thinsp;Poor oral health\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSwallowing Difficulty Scale(EAT-10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Problem exists,2\u0026thinsp;=\u0026thinsp;No problem\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Psychological Cognition Scale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Low,2\u0026thinsp;=\u0026thinsp;Medium,3\u0026thinsp;=\u0026thinsp;High\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharlson Comorbidity Index\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026thinsp;=\u0026thinsp;Low,2\u0026thinsp;=\u0026thinsp;Medium,3\u0026thinsp;=\u0026thinsp;High\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRed blood cell\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubstitute with actual values\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemoglobin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubstitute with actual values\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrealbumin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubstitute with actual values\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"2\"\u003eNote:ADL refers to the ability to perform activities of daily living.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBinary Logistic Regression Analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProject\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eβ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eS.E\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eZ\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOR(95%CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.68(1.90\u0026thinsp;~\u0026thinsp;23.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking history(using non-smoking as the reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.088\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.79(0.92\u0026thinsp;~\u0026thinsp;3.49)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of remaining teeth(based on 20 teeth)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e10 to 19 pieces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.46(1.30\u0026thinsp;~\u0026thinsp;4.65)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 pieces\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.10(1.69\u0026thinsp;~\u0026thinsp;21.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edentures(using yes as the reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-3.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.26(0.13\u0026thinsp;~\u0026thinsp;0.53)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEating habits(based on a balanced diet of meat and vegetables)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMainly meat-based\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.39(0.18\u0026thinsp;~\u0026thinsp;0.83)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimarily vegetarian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.267\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.68(0.34\u0026thinsp;~\u0026thinsp;1.35)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMNA-SF Score(with normal nutrition as reference)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAt risk of malnutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.70(1.11\u0026thinsp;~\u0026thinsp;3.86)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMalnutrition\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.48(2.38\u0026thinsp;~\u0026thinsp;23.55)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eADL(based on basic self-care abilities)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNeed to rely on others\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.056\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.96(0.98\u0026thinsp;~\u0026thinsp;3.89)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral health assessment tool(based on oral health)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor oral health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.58(1.38\u0026thinsp;~\u0026thinsp;4.82)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEAT-10(with reference to the presence of swallowing difficulties)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-1.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-2.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.26(0.11\u0026thinsp;~\u0026thinsp;0.64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote:OR(Odds Ratio)=odds ratio,CI(Confidence Interval)=confidence interval\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"4 Discussion","content":"\u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003e4.1 High Prevalence and Influencing Factors of Oral Frailty in Elderly Patients with Comorbidities\u003c/h2\u003e \u003cp\u003eogistic regression analysis revealed that the prevalence of oral frailty in elderly patients with comorbidities was 78.04%,significantly higher than that reported in some previous studies(such as Lv K\u003csup\u003e[\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]\u003c/sup\u003eand Yin Y\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003e).This difference may be due to:①heterogeneity of the study population.This study focuses on hospitalized elderly patients with comorbidities,who often have \u0026ge;\u0026thinsp;2 chronic conditions.Systemic inflammation,polypharmacy,and functional decline may exacerbate oral health deterioration,thereby increasing the risk of oral frailty.②Differences in measurement methods.Yin Y et al.\u003csup\u003e[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/sup\u003eused the Oral Frailty Index-8(OFI-8)scale and other methods,whereas this study was based on a standardized scale,which may lead to differences in diagnostic rates;Wang XS et al.\u003csup\u003e[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]\u003c/sup\u003estudied patients with a single chronic obstructive pulmonary disease(COPD),finding an oral frailty rate of 35.56%,suggesting the impact of cumulative disease effects\u0026mdash;patients with comorbidities have multisystem involvement,leading to more pronounced oral function decline\u003csup\u003e[\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]\u003c/sup\u003e.③Potential bias in age composition.Zhang JX et al.\u003csup\u003e[\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/sup\u003ereported higher prevalence,with 69.23%of the sample being over 85 years old,while in this study,only 20.67%were over 80.Age,as an independent risk factor for oral frailty,may partially explain the difference.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec23\" class=\"Section2\"\u003e \u003ch2\u003e4.2 Analysis of Factors Affecting Oral Frailty in Elderly Patients with Comorbidities\u003c/h2\u003e \u003cdiv id=\"Sec24\" class=\"Section3\"\u003e \u003ch2\u003e4.2.1 Tooth Loss\u003c/h2\u003e \u003cp\u003eResearch has found that the fewer the number of teeth,the significantly higher the risk of oral frailty(\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05),which is consistent with previous studies\u003csup\u003e[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]\u003c/sup\u003e.The underlying mechanism may be that tooth loss impairs chewing function,hindering thorough chewing and digestion of food,leading to insufficient nutrient intake and absorption,and accelerating muscle atrophy(such as in the tongue and masticatory muscles);missing teeth alter occlusion,further affecting swallowing coordination and nutrient intake;tooth loss can also disturb the balance of oral microbiota,increasing the risk of infection\u003csup\u003e[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003e4.2.2 Dentures\u003c/h2\u003e \u003cp\u003eNot using dentures is a protective factor against oral frailty and can be analyzed from multiple dimensions:①Advantages of natural dentition:Natural teeth form a chain of occlusal force transmission through interproximal contacts,effectively stimulating alveolar bone metabolism to maintain bone density and stability.In contrast,dentures may disrupt these interproximal relationships,leading to imbalanced stress distribution and accelerating local bone resorption\u003csup\u003e[\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]\u003c/sup\u003e.②Biomechanical defects:Implant-supported fixed dentures lack the periodontal ligament structure.Over time,decreased interproximal strength can lead to food impaction,triggering host immune and inflammatory responses,promoting periodontitis,disturbing bone homeostasis,and further increasing the risk of OF\u003csup\u003e[\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]\u003c/sup\u003e.③Adaptive risks:The base stimulation from removable dentures and potential material allergies can easily trigger oral or systemic inflammatory responses.Improper use can cause mechanical injury\u003csup\u003e[\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]\u003c/sup\u003e,compounded by changes in salivary flow and drug-induced dry mouth,directly damaging the oral microenvironment.④Nutritional maintenance ability:Natural dentition maintains masticatory efficiency and nutritional intake,indirectly reducing systemic inflammatory load.In contrast,nausea reactions during the adaptation period to dentures limit dietary variety\u003csup\u003e[\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/sup\u003e,creating a vicious cycle.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003e4.2.3 Dietary Habits\u003c/h2\u003e \u003cp\u003eResearch shows that a diet primarily consisting of meat is a protective factor against oral frailty(P\u0026thinsp;\u0026lt;\u0026thinsp;0.05),which is contrary to the findings of Hwang SY et al.\u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e.Elderly patients with comorbidities often have reduced dietary diversity and insufficient caloric intake.Moderate and balanced consumption of meat provides essential nutrients for the body,promotes muscle synthesis,and maintains oral health.Some elderly individuals,due to tooth loss and swallowing difficulties,choose soft,easy-to-chew meat,which can prevent long-term reliance on a nutritionally limited liquid diet.Additionally,protein contributes to the synthesis of immunoglobulins,enhancing oral immunity and reducing the risk of periodontal infections.Therefore,healthcare professionals should encourage hospitalized elderly patients with comorbidities to consume a reasonably high-protein,nutrient-rich diet to compensate for impaired oral functions.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec27\" class=\"Section3\"\u003e \u003ch2\u003e4.2.4 Malnutrition\u003c/h2\u003e \u003cp\u003eThis study indicates that malnutrition or the risk of malnutrition is a risk factor for OF.This is consistent with the findings of Gao J et al.\u003csup\u003e[\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e]\u003c/sup\u003e.The possible mechanisms include decreased bone mass leading to alveolar bone loosening,tooth loss,and reduced oral function\u003csup\u003e[\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]\u003c/sup\u003e;deficiencies in trace elements in the body leading to oral inflammation(such as oral ulcers);and insufficient muscle strength,resulting in swallowing difficulties and making it hard for traditional diets to meet the normal functioning of the body,thereby increasing the risk of OF\u003csup\u003e[\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec28\" class=\"Section3\"\u003e \u003ch2\u003e4.2.5 Poor Oral Health\u003c/h2\u003e \u003cp\u003eResearch shows that poor oral health is a risk factor for oral frailty in the elderly,consistent with the findings of Zhao X et al.\u003csup\u003e[\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]\u003c/sup\u003e.Poor oral health mainly manifests as dental caries,gum recession,and tooth mobility.The prevalence of dental caries among the elderly is 80.97%\u003csup\u003e[\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]\u003c/sup\u003e.Oral microbial flora causes dental caries through acid production metabolism,acid tolerance,and other pathways.Dental caries leads to reduced saliva secretion,and saliva plays a role in cleaning,buffering,and remineralization.Insufficient saliva secretion diminishes the self-cleaning ability of the oral cavity,causing OF\u003csup\u003e[\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e]\u003c/sup\u003e.Additionally,elderly patients with comorbidities often neglect oral hygiene due to poor daily habits.At the same time,decreased self-care ability and poor adherence to oral health management result in dental problems,such as cavities,not being treated in time.Bacterial infections can then spread to periodontal tissues,causing periodontitis or even tooth mobility;stimulation of the oral mucosa can lead to ulcers and bad breath,increasing the risk of oral frailty.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec29\" class=\"Section3\"\u003e \u003ch2\u003e4.2.6 Swallowing Disorders\u003c/h2\u003e \u003cp\u003eThe results of this study indicate that the absence of swallowing disorders is a protective factor against oral frailty,which is consistent with previous research.Patients with swallowing disorders experience tongue muscle weakness,leading to inadequate chewing and damage to the oral mucosa;delayed pharyngeal reflex causes food to remain,resulting in backward bacterial colonization in the oropharynx and increasing the risk of oral frailty;sarcopenia caused by comorbidities,prolonged nasogastric feeding,or feeding with soft foods leads to disuse atrophy of the oral muscles\u003csup\u003e[\u003cspan additionalcitationids=\"CR41\" citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"5 Conclusions","content":"\u003cp\u003eThis study shows that the prevalence of oral frailty is relatively high among hospitalized elderly patients with comorbidities.Among the included predictive variables,the number of remaining teeth(\u0026lt;\u0026thinsp;10 or 10\u0026ndash;19),malnutrition,and poor oral health are independent risk factors for oral frailty in this population.Factors such as the absence of dentures,absence of swallowing disorders,and dietary habits(mainly meat-based)serve as protective factors against oral frailty.These findings provide important reference points for the early identification and management of high-risk elderly patients in clinical practice.Healthcare professionals can use this information to focus assessments and interventions on individuals with the aforementioned risk characteristics.However,this study has several limitations.First,the cross-sectional design cannot infer causal relationships.Second,as a single-center study,the representativeness of the sample may be limited,and the generalizability of the findings needs to be validated through future multicenter studies.Third one of the limitations of this study is that the age data were collected as categorical variables, making it impossible to calculate and report precise mean age and standard deviation. Future research could consider collecting continuous age data for more in-depth analysis. Finally,some data rely on patient self-reports,which may be subject to recall bias.Future research should adopt a prospective cohort design to clarify the causal pathways between oral frailty and various influencing factors,and on this basis,develop and test targeted interventions to contribute to the goal of healthy aging.\u003c/p\u003e"},{"header":"6 Abbreviations","content":"\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eOF \u0026nbsp; \u0026nbsp; Oral frailty\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eOFI-8 \u0026nbsp; \u0026nbsp; The Oral Frailty Index-8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eMNA-SF \u0026nbsp; \u0026nbsp; Mini Nutritional Assessment-Short Form\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eFFP \u0026nbsp; \u0026nbsp; FRAIL Frailty Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eOHAT \u0026nbsp; \u0026nbsp; Oral Health Assessment Tool\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eAIS \u0026nbsp; \u0026nbsp; Athens Insomnia Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eEAT-10 \u0026nbsp; \u0026nbsp; Eating Assessment Tool-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eCCI \u0026nbsp; \u0026nbsp; Charlson Comorbidity Index\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eSSRS \u0026nbsp; \u0026nbsp; Social Support Rating Scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eMBI \u0026nbsp; \u0026nbsp; Modified Barthel Index\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003eCOPD \u0026nbsp; \u0026nbsp; chronic obstructive pulmonary disease\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 50%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAcknowledgments\u003c/h2\u003e\n\u003cp\u003e\u0026nbsp;We are grateful to all the participants who took part in this study.\u003c/p\u003e\n\u003ch2\u003eAuthor Contributions\u003c/h2\u003e\n\u003cp\u003eXingxing Mi:Made substantial contributions to the study design and methodology,performed the formal analysis and investigation,curated the data,wrote the original draft,and contributed to the review and editing of the manuscript.\u003c/p\u003e\n\u003cp\u003eYa-Mei Yuan:The lead investigator and guarantor of the study.Conceived and designed the study,acquired funding,supervised the project,and contributed to the writing and critical review of the manuscript.\u003c/p\u003e\n\u003cp\u003eTing Wang:Contributed to the methodology and participated in the critical review and editing of the manuscript.\u003c/p\u003e\n\u003cp\u003eWeidong Ye:Contributed to the acquisition of funding for the project. All authors have read and approved the manuscript.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis study was supported by High-Level Talent Support Program of Anhui University of Chinese Medicine(Grant No.2024rcyb021),National Natural Science Foundation of China(NSFC)Youth Project(Grant No.82305187),and2024 Application Transformation of Traditional Chinese Medicine in Preventing and Treating Major Pulmonary Diseases,Anhui Provincial Key Laboratory Project(Grant No.2024ZYFBAHKLA09).\u003c/p\u003e\n\u003ch2\u003eData availability\u003c/h2\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003ch2\u003eEthics approval and consent to participate\u003c/h2\u003e\n\u003cp\u003eThis study was conducted in accordance with the ethical principles of the Declaration of Helsinki and this study involves human participants and was approved by the Ethics Committee of the Second Affiliated Hospital of Anhui University of Chinese Medicine(Approval No.:2024-zjmc-06).Participants gave informed consent to participate in the study before taking part.\u003c/p\u003e\n\u003ch2\u003eConsent for publication\u003c/h2\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003ch2\u003eConflict of Interest\u003c/h2\u003e\n\u003cp\u003eThe author of this work is not required to disclose any.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHuang ZJ. 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Chin Rehabilitation. 2022;37(04):214\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Elderly, chronic disease comorbidity, oral frailty, influencing factors","lastPublishedDoi":"10.21203/rs.3.rs-8629959/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8629959/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground \u003c/strong\u003eInvestigate the incidence of oral frailty in hospitalized elderly patients with comorbidities and explore its influencing factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e Using a convenience sampling method, 397 elderly inpatients from a tertiary hospital in Hefei, Anhui Province, China, from February 2025 to May 2025 were selected as the survey subjects. Data were collected using a general information questionnaire, Oral Frailty Index-8 (OFI-8), FRAIL scale (FFP), Mini Nutritional Assessment-Short Form (MNA-SF), Geriatric Depression Scale-15 (GDS-15), Modified Barthel Index (MBI), Athens Insomnia Scale (AIS), Oral Health Assessment Tool (OHAT), Eating Assessment Tool-10 (EAT-10), Social Support Rating Scale (SSRS), and Charlson Comorbidity Index (CCI). Participants were divided into the oral frailty group (302 cases) and the non-oral frailty group (85 cases) according to whether oral frailty occurred. Clinical data between the two groups were compared, and binary logistic regression was used to analyze the influencing factors of oral frailty.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults \u003c/strong\u003eA total of 387 valid questionnaires were collected,with a response rate of 97.48%.The prevalence of oral frailty among hospitalized elderly patients with comorbidities was 78.04%.Binary logistic regression analysis showed that having 10-19 remaining teeth(OR 2.46,95%CI 1.30-4.65,\u003cem\u003ep\u003c/em\u003e=0.005)or fewer than 10 remaining teeth(OR 6.10,95%CI 1.69-21.99,\u003cem\u003ep\u003c/em\u003e=0.006),being at risk of malnutrition(OR 2.70,95%CI 1.11-3.86,\u003cem\u003ep\u003c/em\u003e=0.021),having malnutrition(OR 7.48,95%CI 2.38-23.55,\u003cem\u003ep\u003c/em\u003e\u0026lt;0.001),and poor oral health(OR 2.58,95%CI 1.38-4.82,\u003cem\u003ep\u003c/em\u003e=0.003)were risk factors for oral frailty in hospitalized elderly patients with comorbidities.Additionally,not having dentures(OR 0.26,95%CI 0.13-0.53,\u003cem\u003ep\u003c/em\u003e\u0026lt;0.001),absence of swallowing disorders(OR 0.26,95%CI 0.11-0.64,\u003cem\u003ep\u003c/em\u003e=0.003),and a diet mainly consisting of meat(OR 0.39,95%CI 0.18-0.83,\u003cem\u003ep\u003c/em\u003e=0.014)were protective factors against oral frailty in this population.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e The incidence of oral frailty is high among hospitalized elderly patients with comorbidities.The number of remaining teeth(\u0026lt;10 or 10~19),malnutrition or risk of malnutrition,and poor oral health are independent risk factors,while having no dentures,no swallowing disorders,and dietary habits(mainly meat-based)are protective factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e not applicable.\u003c/p\u003e","manuscriptTitle":"Current Status and Influencing Factors of Oral Frailty in Hospitalized Elderly Patients with Comorbidities: A Cross-Sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-28 12:23:03","doi":"10.21203/rs.3.rs-8629959/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cb140bb6-fd58-4526-a812-6206598ff353","owner":[],"postedDate":"April 28th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-14T12:35:18+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-13T11:32:27+00:00","index":65,"fulltext":""},{"type":"reviewerAgreed","content":"182355888324585746720384451441021086010","date":"2026-05-10T22:57:05+00:00","index":64,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-05-14T12:40:19+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-28 12:23:03","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8629959","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8629959","identity":"rs-8629959","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}