{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:28:26Z","timestamp":1787020106999,"version":"build-2736575974"},"reference-count":54,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsmedizin Greifswald"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chewing function is critical for maintaining health and well-being in older adults. Impaired chewing efficiency has been linked to systemic conditions such as stroke, respiratory disease, and cognitive decline, as well as increased frailty and its progression. Tooth loss and partial dentition often lead older adults to avoid hard-to-chew, fibre-rich foods, thereby increasing their risk of malnutrition. Despite its importance, chewing function remains under-recognized in geriatric assessments. This study aimed to evaluate chewing efficiency and its association with frailty and nutritional status in geriatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cross-sectional study of 150 consecutive patients at an acute geriatric clinic in Germany. Participants underwent comprehensive geriatric and dental examinations, including a frailty-assessment using the Clinical Frailty Scale (CFS) and a nutritional screening, the Mini Nutritional Assessment short form (MNA). Chewing efficiency was measured using a two-color chewing gum mixing test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 150 patients (mean age 82.3\u2009\u00b1\u20097.6 years, 63.3% female), 28.7% were edentulous. Malnutrition was present in 44.6% of patients, and 47.5% were at risk of malnutrition. Frailty was identified in 81.2% of patients. Lower chewing efficiency was significantly associated with higher frailty (B\u2009=\u20091.36; 95% CI: 0.30, 2.42) and poorer nutritional status (B=-2.46; 95% CI: -4.78, -0.14).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Chewing efficiency, primarily an indicator of oral health, also closely reflects systemic frailty. Preserving oral function and chewing ability may be important for maintaining overall health in older adults. Given the high prevalence of oral health deficits in frail older adults, incorporating a brief dental assessment into routine geriatric care is both feasible and warranted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>The study received approvel from the Ethics Committee of the Universit\u00e4tsmedizin Greifswald, and was registered in the German Clinical Trials Register (DRKS) on 17th April 2024 (registration number: DRKS00033778).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-026-07668-4","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T13:54:00Z","timestamp":1779544440000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Chewing efficiency, nutritional status, and frailty in geriatric patients: a cross-sectional study"],"prefix":"10.1186","volume":"26","author":[{"given":"Wiebke","family":"K\u00f6nning","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birte","family":"Holtfreter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Samietz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Kocher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"issue":"11","key":"7668_CR1","doi-asserted-by":"publisher","first-page":"3997","DOI":"10.1007\/s00784-020-03265-w","volume":"24","author":"F Schwendicke","year":"2020","unstructured":"Schwendicke F, Nitschke I, Stark H, Micheelis W, Jordan RA. Epidemiological trends, predictive factors, and projection of tooth loss in Germany 1997\u20132030: part II. Edentulism in seniors. Clin Oral Investig. 2020;24(11):3997\u20134003. https:\/\/doi.org\/10.1007\/s00784-020-03265-w.","journal-title":"Clin Oral Investig"},{"issue":"4","key":"7668_CR2","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1177\/0022034517693566","volume":"96","author":"NJ Kassebaum","year":"2017","unstructured":"Kassebaum NJ, Smith AGC, Bernab\u00e9 E, Fleming TD, Reynolds AE, Vos T, et al. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990\u20132015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res. 2017;96(4):380\u20137. https:\/\/doi.org\/10.1177\/0022034517693566.","journal-title":"J Dent Res"},{"key":"7668_CR3","unstructured":"Anteile der. Altersgruppen unter 20 Jahren, ab 65 Jahre und ab 80 Jahre (1871\u20132070). Bundesinstitut f\u00fcr Bev\u00f6lkerungsforschung. Available from: https:\/\/www.bib.bund.de\/Permalink.html?cms_permaid=1217820.\u00a0Cited 2024 Oct 9."},{"issue":"3","key":"7668_CR4","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1007\/s00391-022-02053-3","volume":"55","author":"E Sirsch","year":"2022","unstructured":"Sirsch E, Ludwig E, M\u00fcller K, Blumenberg P, Nitschke I, B\u00fcscher A. F\u00f6rderung der Mundgesundheit in der Pflege \u2013 ein interprofessioneller Expertenstandard. Z F\u00fcr Gerontol Geriatr. 2022;55(3):204\u20139. https:\/\/doi.org\/10.1007\/s00391-022-02053-3.","journal-title":"Z F\u00fcr Gerontol Geriatr"},{"key":"7668_CR5","doi-asserted-by":"publisher","unstructured":"Zenth\u00f6fer A, Ehret J, Zajac M, Kilian S, Rammelsberg P, Klotz AL. The effects of dental status and chewing efficiency on the oral-health-related quality of life of nursing-home residents. Clin Interv Aging. 2020;15:2155\u201364. https:\/\/doi.org\/10.2147\/CIA.S273671.","DOI":"10.2147\/CIA.S273671"},{"issue":"2","key":"7668_CR6","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1111\/adj.12064","volume":"58","author":"T Mann","year":"2013","unstructured":"Mann T, Heuberger R, Wong H. The association between chewing and swallowing difficulties and nutritional status in older adults. Aust Dent J. 2013;58(2):200\u20136. https:\/\/doi.org\/10.1111\/adj.12064.","journal-title":"Aust Dent J"},{"key":"7668_CR7","doi-asserted-by":"publisher","first-page":"104186","DOI":"10.1016\/j.jdent.2022.104186","volume":"123","author":"Y Fan","year":"2022","unstructured":"Fan Y, Shu X, Leung KCM, Lo ECM. Associations of general health conditions with masticatory performance and maximum bite force in older adults: A systematic review of cross-sectional studies. J Dent. 2022;123:104186. https:\/\/doi.org\/10.1016\/j.jdent.2022.104186.","journal-title":"J Dent"},{"issue":"2","key":"7668_CR8","doi-asserted-by":"publisher","first-page":"518","DOI":"10.1002\/jnr.24745","volume":"99","author":"T Nakamura","year":"2021","unstructured":"Nakamura T, Zou K, Shibuya Y, Michikawa M. Oral dysfunctions and cognitive impairment\/dementia. J Neurosci Res. 2021;99(2):518\u201328. https:\/\/doi.org\/10.1002\/jnr.24745.","journal-title":"J Neurosci Res"},{"issue":"11","key":"7668_CR9","doi-asserted-by":"publisher","first-page":"3760","DOI":"10.3390\/jcm12113760","volume":"12","author":"M Schimmel","year":"2023","unstructured":"Schimmel M, Anliker N, Sabatini GP, De Paula MS, Weber AR, Molinero-Mourelle P. Assessment and Improvement of Masticatory Performance in Frail Older People: A Narrative Review. J Clin Med. 2023;12(11):3760. https:\/\/doi.org\/10.3390\/jcm12113760.","journal-title":"J Clin Med"},{"key":"7668_CR10","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.archger.2016.12.006","volume":"70","author":"A Tada","year":"2017","unstructured":"Tada A, Miura H. Association between mastication and cognitive status: A systematic review. Arch Gerontol Geriatr. 2017;70:44\u201353. https:\/\/doi.org\/10.1016\/j.archger.2016.12.006.","journal-title":"Arch Gerontol Geriatr"},{"issue":"12","key":"7668_CR11","doi-asserted-by":"publisher","first-page":"4555","DOI":"10.3390\/ijerph17124555","volume":"17","author":"D Watanabe","year":"2020","unstructured":"Watanabe D, Yoshida T, Yokoyama K, Yoshinaka Y, Watanabe Y, Kikutani T, et al. Association between Mixing Ability of Masticatory Functions Measured Using Color-Changing Chewing Gum and Frailty among Japanese Older Adults: The Kyoto\u2013Kameoka Study. Int J Environ Res Public Health. 2020;17(12):4555. https:\/\/doi.org\/10.3390\/ijerph17124555.","journal-title":"Int J Environ Res Public Health"},{"issue":"6","key":"7668_CR12","doi-asserted-by":"publisher","first-page":"860","DOI":"10.1111\/ggi.13264","volume":"18","author":"M Iwasaki","year":"2018","unstructured":"Iwasaki M, Kimura Y, Sasiwongsaroj K, Kettratad-Pruksapong M, Suksudaj S, Ishimoto Y, et al. Association between objectively measured chewing ability and frailty: A cross\u2010sectional study in central Thailand. Geriatr Gerontol Int. 2018;18(6):860\u20136. https:\/\/doi.org\/10.1111\/ggi.13264.","journal-title":"Geriatr Gerontol Int"},{"issue":"11","key":"7668_CR13","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1111\/ggi.14683","volume":"23","author":"S Wang","year":"2023","unstructured":"Wang S, Wang K, Luo L, Wu C, Zhao M, Li M. Chewing difficulty and frailty trajectories in Chinese nursing home residents: A prospective cohort study. Geriatr Gerontol Int. 2023;23(11):803\u20138. https:\/\/doi.org\/10.1111\/ggi.14683.","journal-title":"Geriatr Gerontol Int"},{"issue":"9868","key":"7668_CR14","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","volume":"381","author":"A Clegg","year":"2013","unstructured":"Clegg A, Young J, Iliffe S, Olde Rikkert M, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752\u201362.","journal-title":"Lancet"},{"issue":"3","key":"7668_CR15","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1007\/s00391-021-01873-z","volume":"54","author":"P Benzinger","year":"2021","unstructured":"Benzinger P, Eidam A, Bauer JM. Klinische Bedeutung der Erfassung von Frailty. Z F\u00fcr Gerontol Geriatr. 2021;54(3):285\u201396. https:\/\/doi.org\/10.1007\/s00391-021-01873-z.","journal-title":"Z F\u00fcr Gerontol Geriatr"},{"issue":"8","key":"7668_CR16","doi-asserted-by":"publisher","first-page":"e507","DOI":"10.1016\/S2666-7568(21)00143-4","volume":"2","author":"V Dibello","year":"2021","unstructured":"Dibello V, Zupo R, Sardone R, Lozupone M, Castellana F, Dibello A, et al. Oral frailty and its determinants in older age: a systematic review. Lancet Healthy Longev. 2021;2(8):e507\u201320. https:\/\/doi.org\/10.1016\/S2666-7568(21)00143-4.","journal-title":"Lancet Healthy Longev"},{"issue":"7","key":"7668_CR17","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1007\/s00103-021-03356-3","volume":"64","author":"F Huettig","year":"2021","unstructured":"Huettig F, Schwendicke F. Versorgungsforschung in der Zahnmedizin in Deutschland. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz. 2021;64(7):862\u201370. https:\/\/doi.org\/10.1007\/s00103-021-03356-3.","journal-title":"Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz"},{"issue":"4","key":"7668_CR18","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1111\/ger.12577","volume":"38","author":"LD Slashcheva","year":"2021","unstructured":"Slashcheva LD, Karjalahti E, Hassett LC, Smith B, Chamberlain AM. A systematic review and gap analysis of frailty and oral health characteristics in older adults: A call for clinical translation. Gerodontology. 2021;38(4):338\u201350. https:\/\/doi.org\/10.1111\/ger.12577.","journal-title":"Gerodontology"},{"issue":"5","key":"7668_CR19","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1007\/s12603-016-0793-z","volume":"21","author":"L Jauhiainen","year":"2017","unstructured":"Jauhiainen L, M\u00e4nnist\u00f6 S, Yl\u00f6stalo P, Vehkalahti M, Nordblad A, Turunen AW, et al. Food consumption and nutrient intake in relation to denture use in 55- to 84-year-old men and women \u2014Results of a population based survey. J Nutr Health Aging. 2017;21(5):492\u2013500. https:\/\/doi.org\/10.1007\/s12603-016-0793-z.","journal-title":"J Nutr Health Aging"},{"issue":"2","key":"7668_CR20","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1111\/jcpe.13728","volume":"50","author":"J Shen","year":"2023","unstructured":"Shen J, Qian S, Huang L, Tao Y, Chen H, Deng K, et al. Association of the number of natural teeth with dietary diversity and nutritional status in older adults: A cross-sectional study in China. J Clin Periodontol. 2023;50(2):242\u201351. https:\/\/doi.org\/10.1111\/jcpe.13728 . PubMed PMID: 36122930.","journal-title":"J Clin Periodontol"},{"issue":"1","key":"7668_CR21","doi-asserted-by":"publisher","first-page":"213","DOI":"10.3390\/ijerph18010213","volume":"18","author":"M Iwasaki","year":"2020","unstructured":"Iwasaki M, Motokawa K, Watanabe Y, Shirobe M, Inagaki H, Edahiro A, et al. A Two-Year Longitudinal Study of the Association between Oral Frailty and Deteriorating Nutritional Status among Community-Dwelling Older Adults. Int J Environ Res Public Health. 2020;18(1):213. https:\/\/doi.org\/10.3390\/ijerph18010213.","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"7668_CR22","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1007\/s12603-011-0342-8","volume":"16","author":"A Altenhoevel","year":"2012","unstructured":"Altenhoevel A, Norman K, Smoliner C, Peroz I. The Impact of Self-Perceived Masticatory Function on Nutrition and Gastrointestinal Complaints in the Elderly. J Nutr Health Aging. 2012;16(2):175\u20138. https:\/\/doi.org\/10.1007\/s12603-011-0342-8.","journal-title":"J Nutr Health Aging"},{"issue":"33","key":"7668_CR23","doi-asserted-by":"publisher","first-page":"11987","DOI":"10.1080\/10408398.2022.2098245","volume":"63","author":"A Kumar","year":"2023","unstructured":"Kumar A, Almotairy N, Merzo JJ, Wendin K, Rothenberg E, Grigoriadis A, et al. Chewing and its influence on swallowing, gastrointestinal and nutrition-related factors: a systematic review. Crit Rev Food Sci Nutr. 2023;63(33):11987\u20132017. https:\/\/doi.org\/10.1080\/10408398.2022.2098245.","journal-title":"Crit Rev Food Sci Nutr"},{"key":"7668_CR24","unstructured":"Ikebe K, Matsuda K, ichi, Morii K, Furuya-Yoshinaka M, Nokubi T, Renner RP. Association of Masticatory Performance with Age, Posterior Occlusal Contacts, Occlusal Force, and Salivary Flow in Older Adults. 2006:475\u201381."},{"issue":"10","key":"7668_CR25","doi-asserted-by":"publisher","first-page":"1427","DOI":"10.1007\/s00415-007-0570-3","volume":"254","author":"T Ono","year":"2007","unstructured":"Ono T, Hasegawa Y, Hori K, Nokubi T, Hamasaki T. Task-induced activation and hemispheric dominance in cerebral circulation during gum chewing. J Neurol. 2007;254(10):1427\u201332. https:\/\/doi.org\/10.1007\/s00415-007-0570-3.","journal-title":"J Neurol"},{"issue":"2","key":"7668_CR26","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1016\/j.jpor.2010.09.006","volume":"55","author":"K Kimoto","year":"2011","unstructured":"Kimoto K, Ono Y, Tachibana A, Hirano Y, Otsuka T, Ohno A, et al. Chewing-induced regional brain activity in edentulous patients who received mandibular implant-supported overdentures: A preliminary report. J Prosthodont Res. 2011;55(2):89\u201397. https:\/\/doi.org\/10.1016\/j.jpor.2010.09.006.","journal-title":"J Prosthodont Res"},{"issue":"3","key":"7668_CR27","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/j.neubiorev.2010.06.002","volume":"35","author":"RAF Weijenberg","year":"2011","unstructured":"Weijenberg RAF, Scherder EJA, Lobbezoo F. Mastication for the mind\u2014The relationship between mastication and cognition in ageing and dementia. Neurosci Biobehav Rev. 2011;35(3):483\u201397. https:\/\/doi.org\/10.1016\/j.neubiorev.2010.06.002.","journal-title":"Neurosci Biobehav Rev"},{"issue":"5","key":"7668_CR28","first-page":"370","volume":"34","author":"E Hensel","year":"2003","unstructured":"Hensel E, Gesch D, Biffar R, Bernhardt O, Kocher T, Splieth C, et al. Study of Health in Pomerania (SHIP): a health survey in an East German region. Objectives and design of the oral health section. Quintessence Int Berl Ger 1985. 2003;34(5):370\u20138. PubMed PMID: 12795357.","journal-title":"Quintessence Int Berl Ger 1985"},{"issue":"7 Suppl","key":"7668_CR29","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1902\/jop","volume":"78","author":"RC Page","year":"2007","unstructured":"Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol. 2007;78(7 Suppl):1387\u201399. https:\/\/doi.org\/10.1902\/jop. .2007.060264 PubMed PMID: 17608611.","journal-title":"J Periodontol"},{"issue":"9","key":"7668_CR30","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1111\/j.1365-2842.2007.01773.x","volume":"34","author":"M Schimmel","year":"2007","unstructured":"Schimmel M, Christou P, Herrmann F, M\u00fcller F. A two-colour chewing gum test for masticatory efficiency: development of different assessment methods. J Oral Rehabil. 2007;34(9):671\u20138. https:\/\/doi.org\/10.1111\/j.1365-2842.2007.01773.x.","journal-title":"J Oral Rehabil"},{"issue":"6","key":"7668_CR31","doi-asserted-by":"publisher","first-page":"M366","DOI":"10.1093\/gerona\/56.6.M366","volume":"56","author":"LZ Rubenstein","year":"2001","unstructured":"Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini-Nutritional Assessment (MNA-SF). J Gerontol Biol Sci Med Sci. 2001;56(6):M366\u201372. https:\/\/doi.org\/10.1093\/gerona\/56.6.M366.","journal-title":"J Gerontol Biol Sci Med Sci"},{"issue":"1","key":"7668_CR32","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/0022-3956(82)90033-4","volume":"17","author":"JA Yesavage","year":"1982","unstructured":"Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res. 1982;17(1):37\u201349. https:\/\/doi.org\/10.1016\/0022-3956(82)90033-4.","journal-title":"J Psychiatr Res"},{"issue":"4","key":"7668_CR33","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1093\/ageing\/afu021","volume":"43","author":"G Bellelli","year":"2014","unstructured":"Bellelli G, Morandi A, Davis DHJ, Mazzola P, Turco R, Gentile S, et al. Validation of the 4AT, a new instrument for rapid delirium screening: a study in 234 hospitalised older people. Age Ageing. 2014;43(4):496\u2013502. https:\/\/doi.org\/10.1093\/ageing\/afu021.","journal-title":"Age Ageing"},{"key":"7668_CR34","first-page":"61","volume":"14","author":"FI Mahoney","year":"1965","unstructured":"Mahoney FI, Barthel DW. FUNCTIONAL EVALUATION: THE BARTHEL INDEX. Md State Med J. 1965;14:61\u20135. PubMed PMID: 14258950.","journal-title":"Md State Med J"},{"issue":"1","key":"7668_CR35","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1186\/s12877-020-01801-7","volume":"20","author":"S Church","year":"2020","unstructured":"Church S, Rogers E, Rockwood K, Theou O. A scoping review of the Clinical Frailty Scale. BMC Geriatr. 2020;20(1):393. https:\/\/doi.org\/10.1186\/s12877-020-01801-7.","journal-title":"BMC Geriatr"},{"key":"7668_CR36","unstructured":"Deutsche Gesellschaft f\u00fcr Geriatrie e.V. Clinical Frailty Scale. Available from: https:\/\/www.dggeriatrie.de\/images\/Bilder\/PosterDownload\/200331_DGG_Plakat_A4_Clinical_Frailty_Scale_CFS.pdf.\u00a0Cited 2024 Nov 24."},{"issue":"10","key":"7668_CR37","doi-asserted-by":"publisher","first-page":"754","DOI":"10.1111\/j.1365-2842.2010.02197.x","volume":"38","author":"A Van Der Bilt","year":"2011","unstructured":"Van Der Bilt A. Assessment of mastication with implications for oral rehabilitation: a review: MASTICATION AND ORAL REHABILITATION. J Oral Rehabil. 2011;38(10):754\u201380. https:\/\/doi.org\/10.1111\/j.1365-2842.2010.02197.x.","journal-title":"J Oral Rehabil"},{"issue":"3","key":"7668_CR38","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1111\/ger.12406","volume":"36","author":"FF Hakeem","year":"2019","unstructured":"Hakeem FF, Bernab\u00e9 E, Sabbah W. Association between oral health and frailty: A systematic review of longitudinal studies. Gerodontology. 2019;36(3):205\u201315. https:\/\/doi.org\/10.1111\/ger.12406.","journal-title":"Gerodontology"},{"issue":"12","key":"7668_CR39","doi-asserted-by":"publisher","first-page":"2555","DOI":"10.1111\/jgs.13826","volume":"63","author":"LHDN T\u00f4rres","year":"2015","unstructured":"T\u00f4rres LHDN, Tellez M, Hilgert JB, Hugo FN, De Sousa MDLR, Ismail AI, Frailty. Frailty Components, and Oral Health: A Systematic Review. J Am Geriatr Soc. 2015;63(12):2555\u201362. https:\/\/doi.org\/10.1111\/jgs.13826.","journal-title":"J Am Geriatr Soc"},{"issue":"8","key":"7668_CR40","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1111\/ggi.12399","volume":"15","author":"M Murakami","year":"2015","unstructured":"Murakami M, Hirano H, Watanabe Y, Sakai K, Kim H, Katakura A. Relationship between chewing ability and sarcopenia in Japanese community-dwelling older adults. Geriatr Gerontol Int. 2015;15(8):1007\u201312. https:\/\/doi.org\/10.1111\/ggi.12399.","journal-title":"Geriatr Gerontol Int"},{"key":"7668_CR41","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1016\/j.archger.2017.02.006","volume":"70","author":"EK Kim","year":"2017","unstructured":"Kim EK, Lee SK, Choi YH, Tanaka M, Hirotsu K, Kim HC, et al. Relationship between chewing ability and cognitive impairment in the rural elderly. Arch Gerontol Geriatr. 2017;70:209\u201313. https:\/\/doi.org\/10.1016\/j.archger.2017.02.006.","journal-title":"Arch Gerontol Geriatr"},{"key":"7668_CR42","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3389\/fnagi.2020.00225","volume":"12","author":"S Delwel","year":"2020","unstructured":"Delwel S, Maier AB, Parvaneh D, Meijers J, Scherder EJA, Lobbezoo F. Chewing Efficiency, Global Cognitive Functioning, and Dentition: A Cross-sectional Observational Study in Older People With Mild Cognitive Impairment or Mild to Moderate Dementia. Front Aging Neurosci. 2020;12:225. https:\/\/doi.org\/10.3389\/fnagi.2020.00225 . PubMed PMID: 33033478; PubMed Central PMCID: PMC7510165.","journal-title":"Front Aging Neurosci"},{"issue":"12","key":"7668_CR43","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.3390\/nu11122898","volume":"11","author":"D Azzolino","year":"2019","unstructured":"Azzolino D, Passarelli PC, De Angelis P, Piccirillo GB, D\u2019Addona A, Cesari M. Poor Oral Health as a Determinant of Malnutrition and Sarcopenia. Nutrients. 2019;11(12):2898. https:\/\/doi.org\/10.3390\/nu11122898.","journal-title":"Nutrients"},{"issue":"14","key":"7668_CR44","doi-asserted-by":"publisher","first-page":"2199","DOI":"10.3390\/cells11142199","volume":"11","author":"K Sakai","year":"2022","unstructured":"Sakai K, Nakayama E, Yoneoka D, Sakata N, Iijima K, Tanaka T, et al. Association of Oral Function and Dysphagia with Frailty and Sarcopenia in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. Cells. 2022;11(14):2199. https:\/\/doi.org\/10.3390\/cells11142199.","journal-title":"Cells"},{"key":"7668_CR45","unstructured":"Backheuer LS. Anteil und klinische Charakteristika station\u00e4r behandelter geriatrischer Patienten an einer neurologischen Klinik der Maximalversorgung (Klinik f\u00fcr Neurologie des Universit\u00e4tsklinikums des Saarlandes) [Monographie]. [Homburg\/Saar]: Universit\u00e4t des Saarlandes; 2019. Available from: https:\/\/publikationen.sulb.uni-saarland.de\/bitstream\/20.500.11880\/29313\/1\/Dissertation_Backheuer_Lara.pdf.\u00a0Cited 2025 Jan 27."},{"key":"7668_CR46","unstructured":"Statistische \u00c4mter des Bundes und der L\u00e4nder. Vollstation\u00e4r behandelte Patienten nach Fachabteilungen und Hauptdiagnose nach Wohnsitz - Jahr - regionale Ebenen. (ab 2018) [Statistik (Tabellen)]. Deutschland: FDZ der Statistischen \u00c4mter des Bundes und der L\u00e4nder; 2025. Available from: https:\/\/www.regionalstatistik.de\/genesis\/online?operation=previous&levelindex=3&step=2&titel=Ergebnis&levelid=1737974555756&levelid=1737974429854#abreadcrumb.\u00a0Cited 2025 Jan 27."},{"key":"7668_CR47","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.2147\/CIA.S140859","volume":"12","author":"NAS Abd Aziz","year":"2017","unstructured":"Abd Aziz NAS, Teng NIMF, Abdul Hamid MR, Ismail NH. Assessing the nutritional status of hospitalized elderly. Clin Interv Aging. 2017;12:1615\u201325. doi:10.2147\/CIA.S140859 PubMed PMID: 29042762; PubMed Central PMCID: PMC5634387.","journal-title":"Clin Interv Aging"},{"issue":"4","key":"7668_CR48","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1007\/s00391-023-02208-w","volume":"57","author":"MA Schlenz","year":"2024","unstructured":"Schlenz MA, Schmidt A, G\u00e4bler CS, Kolb G, W\u00f6stmann B. Geriatrisches Assessment in der Zahnmedizin: Eine \u00dcbersicht zu Kaufunktionstests. Z F\u00fcr Gerontol Geriatr. 2024;57(4):308\u201314. https:\/\/doi.org\/10.1007\/s00391-023-02208-w.","journal-title":"Z F\u00fcr Gerontol Geriatr"},{"issue":"11","key":"7668_CR49","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1111\/joor.12696","volume":"45","author":"R Buser","year":"2018","unstructured":"Buser R, Ziltener V, Samietz S, Fontolliet M, Nef T, Schimmel M. Validation of a purpose-built chewing gum and smartphone application to evaluate chewing efficiency. J Oral Rehabil. 2018;45(11):845\u201353. https:\/\/doi.org\/10.1111\/joor.12696.","journal-title":"J Oral Rehabil"},{"key":"7668_CR50","unstructured":"Javadian S. Kaueffizienz und Kaufunktion bei Patienten mit Parodontitis: eine Querschnittsanalyse [Inaugural-Dissertation]. [K\u00f6ln]: Universit\u00e4t zu K\u00f6ln; 2024."},{"issue":"6","key":"7668_CR51","doi-asserted-by":"publisher","first-page":"1409","DOI":"10.1002\/ncp.10877","volume":"37","author":"C \u00d6zs\u00fcrekci","year":"2022","unstructured":"\u00d6zs\u00fcrekci C, Kara M, G\u00fcng\u00f6r AE, Ay\u00e7i\u00e7ek G\u015e, \u00c7al\u0131\u015fkan H, Do\u011fu BB, et al. Relationship between chewing ability and malnutrition, sarcopenia, and frailty in older adults. Nutr Clin Pract. 2022;37(6):1409\u201317. https:\/\/doi.org\/10.1002\/ncp.10877.","journal-title":"Nutr Clin Pract"},{"issue":"6","key":"7668_CR52","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1007\/s00784-024-05742-y","volume":"28","author":"C Sekundo","year":"2024","unstructured":"Sekundo C, Frese C, Alich N, Langowski E, Awounvo S, Wolff D, et al. Very old age impacts masticatory performance: a study among sexagenarians to centenarians. Clin Oral Investig. 2024;28(6):349. https:\/\/doi.org\/10.1007\/s00784-024-05742-y.","journal-title":"Clin Oral Investig"},{"issue":"1","key":"7668_CR53","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1186\/s12903-024-04500-6","volume":"24","author":"A Koenig","year":"2024","unstructured":"Koenig A, Porzelt S, Behrens-Potratz A, Stratmeyer P, Schellhammer S, Schmage P, et al. Assessing oral health-related quality of life among older people in home-based care - survey results of the InSEMaP study in Germany. BMC Oral Health. 2024;24(1):734. https:\/\/doi.org\/10.1186\/s12903-024-04500-6.","journal-title":"BMC Oral Health"},{"key":"7668_CR54","doi-asserted-by":"publisher","first-page":"1514623","DOI":"10.3389\/fpubh.2025.1514623","volume":"13","author":"J Huang","year":"2025","unstructured":"Huang J, Zhang Y, Xv M, Sun L, Wang M. Association between oral health status and frailty in older adults: a systematic review and meta-analysis. Front Public Health. 2025;13:1514623. https:\/\/doi.org\/10.3389\/fpubh.2025.1514623 . PubMed PMID: 40231179; PubMed Central PMCID: PMC11995049.","journal-title":"Front Public Health"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-026-07668-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07668-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07668-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:50:03Z","timestamp":1779684603000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12877-026-07668-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,23]]},"references-count":54,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7668"],"URL":"https:\/\/doi.org\/10.1186\/s12877-026-07668-4","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7547042\/v1","asserted-by":"object"}]},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,23]]},"assertion":[{"value":"5 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study received approval from the Ethics Committee of the Universit\u00e4tsmedizin Greifswald, and was registered in the German Clinical Trials Register (DRKS) on 17th April 2024 (registration number: DRKS00033778). The study was conducted in accordance with the ethical standards outlined in the Delaration of Helsinki. Written informed consent was obtained from all participating patients.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"745"}}