Towards an operational definition of oral frailty: A e-Delphi study

Karl G H Parisius; Merel C Verhoeff; Frank Lobbezoo; Limor Avivi-Arber; Joke Duyck; Hirohiko Hirano; Katsuya Iijima; Barbara Janssens; Anastassia Kossioni; Chia-Shu Lin; Gerald McKenna; Frauke Müller; Martin Schimmel; Anita Visser; Yutaka Watanabe; Robbert J J Gobbens

doi:10.1016/j.archger.2023.105181

Towards an operational definition of oral frailty: A e-Delphi study

Arch Gerontol Geriatr. 2024 Feb:117:105181. doi: 10.1016/j.archger.2023.105181. Epub 2023 Sep 6.

Authors

Karl G H Parisius¹, Merel C Verhoeff², Frank Lobbezoo², Limor Avivi-Arber³, Joke Duyck⁴, Hirohiko Hirano⁵, Katsuya Iijima⁶, Barbara Janssens⁷, Anastassia Kossioni⁸, Chia-Shu Lin⁹, Gerald McKenna¹⁰, Frauke Müller¹¹, Martin Schimmel¹², Anita Visser¹³, Yutaka Watanabe¹⁴, Robbert J J Gobbens¹⁵

Affiliations

¹ Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands; Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands. Electronic address: k.g.h.parisius@acta.nl.
² Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam, ACTA, University of Amsterdam, The Netherlands.
³ University of Toronto, Canada.
⁴ Department of Oral Health Sciences, KU Leuven, Belgium.
⁵ Tokyo Metropolitan Institute for Geriatrics and Gerontology, Japan.
⁶ Institute for Future Initiatives, Institute of Gerontology, The University of Tokyo, Japan.
⁷ Department of Oral Health Sciences, Gerodontology, ELOHA (Equal Lifelong Oral Health for All) research group, Ghent University, Belgium.
⁸ Division of Gerodontology, Department of Prosthodontics, Dental School, National and Kapodistrian University of Athens, Greece.
⁹ Department of Dentistry, National Yang Ming Chiao Tung University, Taiwan.
¹⁰ Centre for Public Health, Queen's University Belfast, Northern Ireland United Kingdom.
¹¹ Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland.
¹² Division of Gerodontology and Removable Prosthdontics, University Clinics of Dental Medicine, University of Geneva, Switzerland; Department of Reconstructive Dentistry and Gerodontology, school of Dental Medicine, University of Bern, Switzerland.
¹³ Department of Gerodontology, Center for Dentistry and Oral Hygiene, University of Groningen, The Netherlands; University Medical Center Groningen, The Netherlands; Department for Gerodontology, College of Dental Sciences, Radboud University Nijmegen Medical Centre, The Netherlands.
¹⁴ Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido, Japan.
¹⁵ Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, The Netherlands; Zonnehuisgroep Amstelland, The Netherlands; Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Tranzo Academic Centre for Transformation in Care and Welfare, Faculty of Behavioural and Social Sciences, Tilburg University, The Netherlands.

PMID: 37713933
DOI: 10.1016/j.archger.2023.105181

Abstract

Objectives: Building upon our recently developed conceptual definition of oral frailty (the age-related functional decline of orofacial structures), this e-Delphi study aims to develop an operational definition of oral frailty by identifying its components.

Methods: We used a modified e-Delphi study to reach a consensus among international experts on the components of oral frailty. Twelve out of fifteen invited experts in the field of gerodontology participated. Experts responded to three rounds of an online 5-point scale questionnaire of components to be included or excluded from the operational definition of oral frailty. After each round, scores and rationales were shared with all experts, after which they could revise their position. A consensus was reached when at least 70% of the experts agreed on whether or not a component should be included in the operational definition of oral frailty.

Results: The experts achieved a high level of agreement (80 - 100%) on including eight components of oral frailty and excluding nineteen. The operational definition of oral frailty should include the following components: 1) difficulty eating hard or tough foods, 2) inability to chew all types of foods, 3) decreased ability to swallow solid foods, 4) decreased ability to swallow liquids, 5) overall poor swallowing function, 6) impaired tongue movement, 7) speech or phonatory disorders, and 8) hyposalivation or xerostomia.

Conclusion: This e-Delphi study provided eight components that make up the operational definition of oral frailty. These components are the foundation for the next stage, which involves developing an oral frailty assessment tool.

Keywords: International consensus; Modified e-Delphi study; Operational definition; Oral frailty; Oral function.

MeSH terms

Consensus
Delphi Technique
Frailty* / diagnosis
Humans
Surveys and Questionnaires