ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1607065
This article is part of the Research TopicOral Health and Care in the Elderly Population and Aging SocietyView all 5 articles
Oral Health Associates with Frailty in Chinese Older Adults: A Chain Mediating Model of Sleep Quality and Depressive Symptoms
Provisionally accepted
- School of Nursing, Anhui Medical University, Hefei, Anhui Province, China
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Objective: With the acceleration of the global aging process, frailty has emerged as a significant public health issue impacting the health of the older adults. Additionally, oral health problems associated with aging require urgent attention. This study aims to examine the association between oral health status and frailty in older adults and to analyze the mediating roles of sleep quality and depressive symptoms to provide recommendations for alleviating frailty. Methods: This is a population-based cross-sectional study conducted in China from November 2024 to February 2025, involving 345 older adults aged 60 years or older. The study completed measures of sociodemographic information, oral health status, sleep quality, depressive symptoms, and frailty. Pearson correlation analysis tested the correlations between the variables, and chain mediation effects were examined using PROCESS macro (Model 6) with 5000 bootstrap samples. Statistical significance was set at P<0.05. Results: This study showed a positive correlation between oral health status, sleep quality, depressive symptoms and frailty (r = 0.457~0.583; all P <0.001), the indirect effects of oral health status on frailty mediated by sleep quality, depressive symptoms were 0.073 (95% CI =[0.002~0.144]), 0.085 (95%CI=[0.032~0.148]), the effect mediated by both sleep quality and depressive symptoms was 0.090 (95%CI= [0.049~0.148]). The total indirect effect value of sleep quality and depressive symptoms between oral health status and frailty was 0.248 (95% CI =[0.161~0.347]), accounting for 52.54% of the total effect. Conclusion: Our findings suggest that sleep quality and depressive symptoms are associated with the relationship between oral health status and frailty in older adults, indicating potential intervention targets including oral health care, sleep improvement, and mental health management to assist in slowing the process of frailty.
Keywords: Oral Health, Frailty, sleep quality, depressive symptoms, chain mediation, older adults
Received: 17 Apr 2025; Accepted: 03 Oct 2025.
Copyright: © 2025 Chen, Song, Zhou and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Dan Su, sudan20230906@163.com
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