{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:28:03Z","timestamp":1787304483528,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Tooth loss is common in older adults and has been associated with adverse health outcomes, but its relationship with intrinsic capacity (IC), a multidimensional indicator of healthy aging, remains insufficiently understood. Whether social support is involved in this association is also unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 421 hospitalized adults aged 60 years or older who were recruited from Peking Union Medical College Hospital, Beijing, between February and May 2022. The number of natural teeth was assessed by direct visual inspection of the oral cavity by a trained nurse during routine admission assessment. IC was evaluated using six components derived from five World Health Organization domains: locomotion, cognition, vitality, psychological function, hearing, and vision. Participants with impairment in at least one component (IC score \u2264 5 of 6) were classified as having declined IC. Social support was measured using the Multidimensional Scale of Perceived Social Support. Multivariable logistic regression was used to examine the association between natural-tooth count and declined IC. Exploratory structural equation modeling (SEM) was used to assess an indirect statistical pathway involving social support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 421 participants (mean age, 71.5 \u00b1 6.3 years; 60.6% male), 66.98% had declined IC. Compared with participants with \u226520 natural teeth, those with &amp;lt; 20 natural teeth had higher odds of declined IC after adjustment for sociodemographic, clinical, and behavioral factors and Charlson Comorbidity Index (OR = 3.11, 95% CI: 1.82\u20135.32,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). When natural-tooth count was modeled continuously, each additional tooth was associated with lower odds of declined IC (OR = 0.96, 95% CI: 0.93\u20130.98,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001). In exploratory SEM using the 0\u20136 IC score, a significant indirect association through social support was observed (\u03b2 = 0.009, 95% CI: 0.005\u20130.014,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), accounting descriptively for 41.8% of the total statistical association.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Fewer natural teeth were associated with declined IC among hospitalized older adults. Social support may be involved in this association, but the cross-sectional design precludes causal interpretation. These findings support incorporating oral health assessment into geriatric care and warrant longitudinal studies to clarify temporal pathways.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1848888","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:10:23Z","timestamp":1787303423000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Number of natural teeth and intrinsic capacity among hospitalized older adults in China: a cross-sectional study on the role of social support"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoming","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Emergency, The People's Hospital of Bao'an","place":["Shenzhen, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinjuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"106206","DOI":"10.1016\/j.archger.2026.106206","article-title":"Multi-trajectories of intrinsic capacity and their impact on incident disability in community-dwelling older adults in Japan","volume":"145","author":"Zhang","year":"2026","journal-title":"Arch Gerontol Geriatr."},{"key":"B2","doi-asserted-by":"publisher","first-page":"108709","DOI":"10.1016\/j.maturitas.2025.108709","article-title":"The role of intrinsic capacity in predicting cancer mortality-evidence from the UK Biobank","volume":"202","author":"Calatayud","year":"2025","journal-title":"Maturitas."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e045986","DOI":"10.1161\/JAHA.125.045986","article-title":"Associations of baseline and changes in intrinsic capacity with incident cardiovascular disease: a multicohort study","volume":"15","author":"Tang","year":"2026","journal-title":"J American Heart Association."},{"key":"B4","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1186\/s12877-025-06289-7","article-title":"Declined intrinsic capacity is associated with one-year functional disability in older hypertensive inpatients","volume":"25","author":"Zeng","year":"2025","journal-title":"BMC Geriatr."},{"key":"B5","doi-asserted-by":"publisher","first-page":"100773","DOI":"10.1016\/j.jnha.2026.100773","article-title":"Intrinsic capacity and risk of hip fracture in older adults: evidence from five multinational aging cohorts","volume":"30","author":"Zhang","year":"2026","journal-title":"J Nutr Health Aging."},{"key":"B6","doi-asserted-by":"publisher","first-page":"105950","DOI":"10.1016\/j.jamda.2025.105950","article-title":"Effect size estimates of risk factors for the impaired intrinsic capacity among community-dwelling older adults: a systematic review and meta-analysis","volume":"26","author":"Gao","year":"2025","journal-title":"J Am Med Dir Assoc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"971223","DOI":"10.3389\/froh.2022.971223","article-title":"Your health is in your mouth: a comprehensive view to promote general wellness","volume":"3","author":"Barranca-Enr\u00edquez","year":"2022","journal-title":"Front Oral Health."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2507","DOI":"10.3390\/nu17152507","article-title":"Chewing matters: masticatory function, oral microbiota, and gut health in the nutritional management of aging","volume":"17","author":"Lettieri","year":"2025","journal-title":"Nutrients."},{"key":"B9","doi-asserted-by":"publisher","first-page":"213","DOI":"10.3290\/j.cjdr.a41077","article-title":"Dental caries in Chinese elderly people: findings from the 4th national oral health survey","volume":"21","author":"Gao","year":"2018","journal-title":"Chinese J Dental Res."},{"key":"B10","doi-asserted-by":"publisher","first-page":"e70136","DOI":"10.1111\/1753-0407.70136","article-title":"Periodontal disease: a contributing factor to adverse outcome in diabetes","volume":"17","author":"El","year":"2025","journal-title":"J Diabetes."},{"key":"B11","doi-asserted-by":"publisher","first-page":"2898","DOI":"10.3390\/nu11122898","article-title":"Poor oral health as a determinant of malnutrition and Sarcopenia","volume":"11","author":"Azzolino","year":"2019","journal-title":"Nutrients."},{"key":"B12","doi-asserted-by":"publisher","first-page":"igaf086","DOI":"10.1093\/geroni\/igaf086","article-title":"Accelerated biological aging mediates the association between periodontal disease and cognitive function in older adults","volume":"9","author":"Qi","year":"2025","journal-title":"Innov Aging"},{"key":"B13","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s12889-021-12457-2","article-title":"Tooth loss and associated self-rated health and psychological and subjective wellbeing among community-dwelling older adults: a cross-sectional study in India","volume":"22","author":"Muhammad","year":"2022","journal-title":"BMC Public Health."},{"key":"B14","doi-asserted-by":"publisher","first-page":"821","DOI":"10.1111\/joor.70138","article-title":"Tooth loss as a risk factor of declining intrinsic capacity domains in later life: evidence from NHANES 2009-2014","volume":"53","author":"Dibello","year":"2026","journal-title":"J Oral Rehabil."},{"key":"B15","doi-asserted-by":"publisher","first-page":"4157","DOI":"10.1007\/s11357-025-01884-3","article-title":"Association between periodontal disease and intrinsic capacity in older adults: insights from NHANES 2009-2014","volume":"48","author":"Dibello","year":"2025","journal-title":"GeroScience."},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-025-06601-0","article-title":"Associations among self-reported oral health and intrinsic capacity domains in U","author":"Dibello","year":"2025","journal-title":"Clin Oral Inves"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1747285","DOI":"10.3389\/fpubh.2026.1747285","article-title":"The influence of social support on active aging in chronic disease patients among older adults: mediating role of coping strategies","volume":"14","author":"Jian","year":"2026","journal-title":"Front Public Health."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2222","DOI":"10.1007\/978-981-287-082-7_110","article-title":"Socioemotional selectivity theory","author":"English","year":"2017","journal-title":"Encyclopedia of Geropsychology"},{"key":"B19","doi-asserted-by":"publisher","first-page":"859","DOI":"10.1186\/s12877-023-04570-1","article-title":"New measure of functional tooth loss for successful oral ageing: a cross-sectional study","volume":"23","author":"Cheng","year":"2023","journal-title":"BMC Geriatr."},{"key":"B20","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1186\/s12877-025-06697-9","article-title":"Cumulative effect of intrinsic capacity domains on geriatric syndromes and functionality in older inpatients","volume":"25","author":"Gencer","year":"2025","journal-title":"BMC Geriatr."},{"key":"B21","doi-asserted-by":"publisher","first-page":"e213401","DOI":"10.1212\/WNL.0000000000213401","article-title":"et al. Montreal cognitive assessment vs the mini-mental state examination as a screening tool for patients with genetic frontotemporal dementia","volume":"104","author":"de Boer","year":"2025","journal-title":"Neurology"},{"key":"B22","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1080\/13607863.2012.758231","article-title":"Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment","volume":"17","author":"Conradsson","year":"2013","journal-title":"Aging Ment Health."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment","author":"Chen","year":"2020","journal-title":"J Am Med Direc Assoc"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e0297546","DOI":"10.1371\/journal.pone.0297546","article-title":"Oral health community engagement programs for rural communities: a scoping review","volume":"19","author":"Nghayo","year":"2024","journal-title":"PLoS ONE."},{"key":"B25","doi-asserted-by":"publisher","first-page":"79","DOI":"10.5093\/pi2025a7","article-title":"Validation of the multidimensional scale of perceived social support (MSPSS) in a representative sample of adolescents: links with well-being, mental health, and suicidal behavior","volume":"34","author":"Pina","year":"2025","journal-title":"Psychol Interv."},{"key":"B26","doi-asserted-by":"publisher","first-page":"2233","DOI":"10.2147\/PRBM.S463245","article-title":"Psychometric properties of the Chinese version of multidimensional scale of perceived social support","volume":"17","author":"Yang","year":"2024","journal-title":"Psychol Res Behav Manag."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1007\/s41999-024-00956-5","article-title":"Association between intrinsic capacity and oral health in older patients in a frailty clinic","volume":"15","author":"Miyahara","year":"2024","journal-title":"Eur Geriatr Med."},{"key":"B28","doi-asserted-by":"publisher","first-page":"893","DOI":"10.3390\/nu18060893","article-title":"The effect of tooth loss on depression and anxiety among older adults in China: the mediating role of dietary diversity","volume":"18","author":"Wang","year":"2026","journal-title":"Nutrients."},{"key":"B29","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1590\/1413-81232018241.09252017","article-title":"Tooth loss experiences in adult and elderly users of primary health care","volume":"24","author":"Bitencourt","year":"2019","journal-title":"Cien Saude Colet."},{"key":"B30","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1186\/s12903-025-07329-9","article-title":"Unmasking oral health stigma: a qualitative scoping review","volume":"26","author":"Doughty","year":"2025","journal-title":"BMC Oral Health."},{"key":"B31","doi-asserted-by":"publisher","first-page":"112923","DOI":"10.1016\/j.exger.2025.112923","article-title":"Development and validation of an interpretable machine learning model for predicting intrinsic capacity decline in elderly inpatients","volume":"211","author":"Li","year":"2025","journal-title":"Exp Gerontol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"2359","DOI":"10.1038\/s43587-025-00993-0","article-title":"Embedding oral health indicators into multidimensional frailty models","volume":"5","author":"Dibello","year":"2025","journal-title":"Nature Aging."},{"key":"B33","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1186\/s12877-025-05854-4","article-title":"Comprehensive geriatric assessment for oral care in older adults: a focus group study","volume":"25","author":"Wongiam","year":"2025","journal-title":"BMC Geriatr."},{"key":"B34","doi-asserted-by":"publisher","first-page":"1604465","DOI":"10.3389\/froh.2025.1604465","article-title":"Enhancing oral health outcomes through public health policy reform","volume":"6","author":"Anyikwa","year":"2025","journal-title":"Front Oral Health."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1848888\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T09:10:24Z","timestamp":1787303424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1848888\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":34,"alternative-id":["10.3389\/fmed.2026.1848888"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1848888","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"1848888"}}