{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T02:04:34Z","timestamp":1790647474889,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Oral Rehabilitation"],"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Oral frailty describes an emerging geriatric oral condition featuring progressive oral function decline linked to adverse health outcomes among older adults. Older adults living in long\u2010term care facilities are particularly vulnerable due to advanced age, multimorbidity and reduced self\u2010care capacity. However, longitudinal patterns of oral frailty progression and individual heterogeneity remain unclear.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This study aimed to identify distinct longitudinal trajectories of oral frailty among older adults residing in long\u2010term care facilities and to examine baseline clinical characteristics associated with different trajectory memberships.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A prospective longitudinal study was conducted among 295 older adults from six long\u2010term care facilities in Chengdu, China, between March and December 2025. Oral frailty was assessed using the Oral Frailty Index\u20108 (OFI\u20108) at baseline and at 1\u2010, 3\u2010 and 6\u2010month follow\u2010ups. Latent growth mixture modelling (LGMM) was used to identify oral frailty trajectories.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Three distinct oral frailty trajectories were identified: a low\u2010level persistent stable group (46.3%), a moderate\u2010level gradual recovery group (34.4%) and a high\u2010level progressive deterioration group (19.3%). Cognitive impairment, nutritional status, insomnia, number of chronic diseases and long\u2010term alcohol consumption were key clinical indicators distinguishing the three trajectory groups.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Oral frailty progression among older adults in long\u2010term care facilities shows substantial heterogeneity. Trajectory\u2010based assessment incorporating cognitive, nutritional and chronic disease\u2010related indicators may facilitate early identification of high\u2010risk individuals and support personalized oral health interventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/joor.70329","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:45:44Z","timestamp":1790646344000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heterogeneous Trajectories of Oral Frailty Among Institutionalized Older Adults: A 6\u2010Month Latent Growth Mixture Modelling Study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1172-7926","authenticated-orcid":false,"given":"Hong","family":"Chen","sequence":"first","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9268-2202","authenticated-orcid":false,"given":"Yunlan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Hospital of Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1023-0998","authenticated-orcid":false,"given":"Xiaodi","family":"Bai","sequence":"additional","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5972-863X","authenticated-orcid":false,"given":"Le","family":"Li","sequence":"additional","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuelin","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senlin","family":"Wu","sequence":"additional","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0960-3958","authenticated-orcid":false,"given":"Mengjie","family":"Zhang","sequence":"additional","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8532-804X","authenticated-orcid":false,"given":"Xiaoyu","family":"Bai","sequence":"additional","affiliation":[{"name":"College of Nursing Chengdu University of Traditional Chinese Medicine Chengdu Sichuan Province P. R. China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"United Nations Department of Economic and Social Affairs Population Division \u201cWorld Population Prospects 2019: Highlights(ST\/ESA\/SER.A\/423) \u201d(2019)."},{"issue":"1","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1186\/s12877-025-05807-x","article-title":"Association Between Nap Time, Nighttime Sleep, and Multimorbidity in Chinese Older Adults: A Cross\u2010Sectional Study","volume":"25","author":"Song Y.","year":"2025","journal-title":"BMC Geriatrics"},{"issue":"3","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"mzad054","DOI":"10.1093\/intqhc\/mzad054","article-title":"Effect of China's Long\u2010Term Care Insurance on Health Outcomes of Older Disabled People: Role of Institutional Care","volume":"35","author":"Zhou J.\u2010Q.","year":"2023","journal-title":"International Journal for Quality in Health Care"},{"issue":"4","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.edumed.2025.101050","article-title":"Abordando la Soledad en la Formaci\u00f3n de Profesionales Sanitarios y en la Pr\u00e1ctica Cl\u00ednica","volume":"26","author":"Parra\u2010Rizo M. A.","year":"2025","journal-title":"Educaci\u00f3n M\u00e9dica"},{"issue":"11","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"527","DOI":"10.3390\/dj13110527","article-title":"Oral Health Care for Institutionalized Elderly in Romania: Needs, Barriers, and Legislative Gaps","volume":"13","author":"Cosoroab\u0103 R. M.","year":"2025","journal-title":"Dentistry Journal"},{"issue":"6","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1111\/ggi.13921","article-title":"Oral Health for Achieving Longevity","volume":"20","author":"Watanabe Y.","year":"2020","journal-title":"Geriatrics & Gerontology International"},{"issue":"6","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1093\/ageing\/afab177","article-title":"Relationship Between Fried's Frailty Phenotype and Oral Frailty in Long\u2010Term Care Residents","volume":"50","author":"Hiltunen K.","year":"2021","journal-title":"Age and Ageing"},{"issue":"12","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1093\/gerona\/glx225","article-title":"Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community\u2010Dwelling Elderly","volume":"73","author":"Tanaka T.","year":"2018","journal-title":"Journals of Gerontology. Series A, Biological Sciences and Medical Sciences"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"1979","DOI":"10.2147\/CIA.S487329","article-title":"Unfavourable Outcomes in Older Adults With Oral Frailty: A Scoping Review","volume":"19","author":"Zhu S. R.","year":"2024","journal-title":"Clinical Interventions in Aging"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.exger.2022.112075","article-title":"Oral Frailty as a Risk Factor for Mild Cognitive Impairment in Community\u2010Dwelling Older Adults: Kashiwa Study","volume":"172","author":"Nagatani M.","year":"2023","journal-title":"Experimental Gerontology"},{"issue":"6","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1007\/s00784-023-04906-6","article-title":"Dental Status and Its Correlation With Polypharmacy and Multimorbidity in a Swiss Nursing Home Population: A Cross\u2010Sectional Study","volume":"27","author":"Anliker N.","year":"2023","journal-title":"Clinical Oral Investigations"},{"issue":"2","key":"e_1_2_10_13_1","first-page":"171","article-title":"Current Status and Influencing Factors of Oral Frailty Among Older Adults in Long\u2010Term Care Facilities","volume":"25","author":"Zhang J. X.","year":"2025","journal-title":"Journal of Nursing Administration"},{"issue":"2","key":"e_1_2_10_14_1","first-page":"261","article-title":"Prevalence of Oral Frailty and Construction of Risk Prediction Model for Older Adults in Anhui Province","volume":"41","author":"Jiang W. Y.","year":"2025","journal-title":"Journal of Practical Stomatology"},{"issue":"3","key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1007\/s41999-023-00930-7","article-title":"The Prevalence of Oral Frailty Among Older Adults: A Systematic Review and Meta\u2010Analysis","volume":"15","author":"Li T.","year":"2024","journal-title":"European Geriatric Medicine"},{"issue":"59","key":"e_1_2_10_16_1","doi-asserted-by":"crossref","DOI":"10.1590\/1980-220x-reeusp-2025-0020en","article-title":"Factors Associated With Oral Frailty in Elderly Stroke Patients in Eastern China","volume":"8","author":"Jiayue Z.","year":"2025","journal-title":"Revista da Escola de Enfermagem da USP"},{"issue":"10","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1592\/phco.30.10.973","article-title":"Methods in Epidemiology: Observational Study Designs","volume":"30","author":"DiPietro N. A.","year":"2010","journal-title":"Pharmacotherapy"},{"issue":"5","key":"e_1_2_10_18_1","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1177\/1474515120911330","article-title":"Identifying Subgroups: Part 2: Trajectories of Change Over Time","volume":"19","author":"Lee C. S.","year":"2020","journal-title":"European Journal of Cardiovascular Nursing"},{"key":"e_1_2_10_19_1","article-title":"Frailty Trajectories and Determinants in Older Adults After PCI: A Longitudinal Study","volume":"21","author":"Yao L.","year":"2026","journal-title":"Clinical Interventions in Aging"},{"issue":"4","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1177\/0956797615626703","article-title":"Supportive Family Environments Ameliorate the Link Between Racial Discrimination and Epigenetic Aging: A\u2009Replication Across Two Longitudinal Cohorts","volume":"27","author":"Brody G. H.","year":"2016","journal-title":"Psychological Science"},{"issue":"1","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"44676","DOI":"10.1038\/s41598-025-31111-0","article-title":"Association Between Group\u2010Based Trajectory Modeling of Blood Glucose and Acute Delirium Incidence in Critically Ill Patients: A Retrospective Cohort Study Based on the MIMIC\u2010IV Database","volume":"15","author":"Guan B.","year":"2025","journal-title":"Scientific Reports"},{"issue":"4","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.3758\/BRM.41.4.1083","article-title":"Statistical Power Analysis for Growth Curve Models Using SAS","volume":"41","author":"Zhang Z.","year":"2009","journal-title":"Behavior Research Methods"},{"issue":"30","key":"e_1_2_10_23_1","first-page":"3810","article-title":"Meta\u2010Analysis of the Prevalence of Oral Frailty in the Elderly","volume":"27","author":"Qiao W. W.","year":"2024","journal-title":"Chinese General Practice"},{"key":"e_1_2_10_24_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.archger.2021.104340","article-title":"Oral Frailty Index\u20108 in the Risk Assessment of New\u2010Onset Oral Frailty and Functional Disability Among Community\u2010Dwelling Older Adults","volume":"94","author":"Tanaka T.","year":"2021","journal-title":"Archives of Gerontology and Geriatrics"},{"issue":"3","key":"e_1_2_10_25_1","first-page":"189","article-title":"\u2018Mini\u2010Mental State\u2019. A Practical Method for Grading the Cognitive State of Patients for the Clinician","volume":"12","author":"Folstein M. F.","year":"1975","journal-title":"Journal of Psychiatric Research"},{"issue":"6","key":"e_1_2_10_26_1","doi-asserted-by":"crossref","first-page":"M366","DOI":"10.1093\/gerona\/56.6.M366","article-title":"Screening for Undernutrition in Geriatric Practice: Developing the Short\u2010Form Mini\u2010Nutritional Assessment (MNA\u2010SF)","volume":"56","author":"Rubenstein L. Z.","year":"2001","journal-title":"Journals of Gerontology. Series A, Biological Sciences and Medical Sciences"},{"issue":"2","key":"e_1_2_10_27_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jamda.2014.12.002","article-title":"Frailty in Nursing Homes: The FRAIL\u2010NH Scale","volume":"16","author":"Kaehr E.","year":"2015","journal-title":"Journal of the American Medical Directors Association"},{"issue":"9","key":"e_1_2_10_28_1","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ\u20109: Validity of a Brief Depression Severity Measure","volume":"16","author":"Kroenke K.","year":"2001","journal-title":"Journal of General Internal Medicine"},{"issue":"12","key":"e_1_2_10_29_1","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/j.jamda.2018.10.007","article-title":"Practical Guidelines for Physicians in Promoting Oral Health in Frail Older Adults","volume":"19","author":"Kossioni E. A.","year":"2018","journal-title":"Journal of the American Medical Directors Association"},{"issue":"1","key":"e_1_2_10_30_1","doi-asserted-by":"crossref","first-page":"5463","DOI":"10.1038\/s41598-025-89910-4","article-title":"Oral Health of Nursing Home Residents in Flanders, Belgium, and Its Associated Factors","volume":"15","author":"Vandenbulcke P. A. I.","year":"2025","journal-title":"Scientific Reports"},{"issue":"12","key":"e_1_2_10_31_1","doi-asserted-by":"crossref","DOI":"10.3390\/nu11122898","article-title":"Poor Oral Health as a Determinant of Malnutrition and Sarcopenia","volume":"11","author":"Azzolino D.","year":"2019","journal-title":"Nutrients"},{"issue":"4","key":"e_1_2_10_32_1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1007\/s40266-023-01017-5","article-title":"From Drugs to Dry Mouth: A Systematic Review Exploring Oral and Psychological Health Conditions Associated With Dry Mouth in Older Adults With Polypharmacy","volume":"40","author":"Cannon I.","year":"2023","journal-title":"Drugs & Aging"},{"issue":"1","key":"e_1_2_10_33_1","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1186\/s12903-023-03686-5","article-title":"Investigating Oral Health Among US Adults With Sleep Disorder: A Cross\u2010Sectional Study","volume":"23","author":"Movahed E.","year":"2023","journal-title":"BMC Oral Health"},{"issue":"6","key":"e_1_2_10_34_1","article-title":"Alcohol and Periodontal Disease: A Narrative Review","volume":"16","author":"Gandhi U. H.","year":"2024","journal-title":"Cureus"}],"container-title":["Journal of Oral Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70329","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joor.70329","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joor.70329","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:45:50Z","timestamp":1790646350000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joor.70329"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,28]]},"references-count":33,"alternative-id":["10.1111\/joor.70329"],"URL":"https:\/\/doi.org\/10.1111\/joor.70329","archive":["Portico"],"relation":{},"ISSN":["0305-182X","1365-2842"],"issn-type":[{"value":"0305-182X","type":"print"},{"value":"1365-2842","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,28]]},"assertion":[{"value":"2026-07-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"joor.70329"}}