{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T05:18:31Z","timestamp":1792819111807,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross\u2010sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The analysis included 2727 late\u2010stage older adults (mean age 79.9\u2009\u00b1\u20094.3\u2009years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1\u2010point increase 0.88, 95% confidence interval 0.84\u20130.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92\u20130.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Oral frailty was associated with decreased appetite and dietary variety in late\u2010stage older adults.\n                      <jats:bold>Geriatr Gerontol Int 2024; 24: 626\u2013633<\/jats:bold>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.14892","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T22:20:02Z","timestamp":1715120402000},"page":"626-633","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Oral frailty, appetite and dietary variety in late\u2010stage older adults: A cross\u2010sectional study (the\n                    <scp>STudy<\/scp>\n                    of\n                    <scp>lAte<\/scp>\n                    \u2010stage\n                    <scp>oldeR adulTs<\/scp>\n                    in Tottori;\n                    <scp>START<\/scp>\n                    Tottori)"],"prefix":"10.1111","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4339-030X","authenticated-orcid":false,"given":"Sayuri","family":"Nakagawa","sequence":"first","affiliation":[{"name":"Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9420-7672","authenticated-orcid":false,"given":"Kazuhito","family":"Miura","sequence":"additional","affiliation":[{"name":"Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eri","family":"Arai","sequence":"additional","affiliation":[{"name":"Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenshu","family":"Taira","sequence":"additional","affiliation":[{"name":"Department of Public Health and Hygiene Graduate School of Medicine, University of the Ryukyus  Okinawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4983-2399","authenticated-orcid":false,"given":"Yutaka","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maki","family":"Shirobe","sequence":"additional","affiliation":[{"name":"Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Motokawa","sequence":"additional","affiliation":[{"name":"Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Ohara","sequence":"additional","affiliation":[{"name":"Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5739-2936","authenticated-orcid":false,"given":"Masanori","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirohiko","family":"Hirano","sequence":"additional","affiliation":[{"name":"Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiro","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Prosthodontics, Gerodontology and Oral Rehabilitation Osaka University Graduate School of Dentistry  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Adachi","sequence":"additional","affiliation":[{"name":"Tottori Dental Association  Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takao","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Tottori Dental Association  Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine Hokkaido University  Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Cabinet Office.Government of Japan. White Paper on Aging Society. Resource document 2023. Available from:https:\/\/www8.cao.go.jp\/kourei\/whitepaper\/w-2023\/zenbun\/pdf\/1s1s_01.pdf."},{"key":"e_1_2_9_3_1","unstructured":"The Ministry of Health Labour and Welfare.Health Japan 21 (The Second Term) [Cited 7 Oct 2019.] Available from:https:\/\/www.mhlw.go.jp\/stf\/seisakunitsuite\/bunya\/kenkou_iryou\/kenkou\/kenkounippon21.html."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.13921"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.1392110.1111\/jgs.14355"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.1392110.1093\/gerona\/glx225"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/s2666-7568(21)00143-4"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/63.9.984"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12092885"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-018-1000-1"},{"key":"e_1_2_9_11_1","unstructured":"Statistics Bureau.Portal Site of Official Statistics of Japan 2020. [Cited 8 Feb 2024.] Available from:https:\/\/www.e-stat.go.jp\/dbview?sid=0003445097."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.13163"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.08.001"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2004.07.015"},{"key":"e_1_2_9_15_1","first-page":"1117","article-title":"Effects of dietary variety on declines in high\u2010level functional capacity in elderly people living in a community","volume":"50","author":"Kumagai S","year":"2003","journal-title":"Nihon Koshu Eisei Zasshi"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1006\/brln.2001.2614"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-2358.2012.00647.x"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/ger.12347"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2008.02.002"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.je.2016.11.002"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-016-0726-x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.11236\/jph.67.3_171"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2022.111929"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/ger.12406"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/joor.13122"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/26.6.445"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0063539"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-019-1224-8"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2004.07.011"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-023-03129-5"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1988.tb01785.x"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jtxs.12573"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1741-2358.2008.00258.x"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/ger.12468"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03177-2"},{"key":"e_1_2_9_37_1","unstructured":"The Ministry of Health Labour and Welfare.Survey of dental diseases 2022 (in Japanese). Available from:https:\/\/www.mhlw.go.jp\/stf\/newpage_33814.html."},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12426"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13264"},{"key":"e_1_2_9_40_1","first-page":"62","article-title":"Relationship between dietary diversity and oral function among older women aged 75\u2009years and over participating in community\u2010based health exercise programs","volume":"15","author":"Miyoshi S","year":"2021","journal-title":"J Jpn Soc Dent Hyg"}],"container-title":["Geriatrics &amp; Gerontology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.14892","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T09:12:42Z","timestamp":1758013962000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ggi.14892"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,7]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1111\/ggi.14892"],"URL":"https:\/\/doi.org\/10.1111\/ggi.14892","archive":["Portico"],"relation":{},"ISSN":["1444-1586","1447-0594"],"issn-type":[{"value":"1444-1586","type":"print"},{"value":"1447-0594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,7]]},"assertion":[{"value":"2023-12-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-05-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}