Cross-cultural Adaptation of Oral and Maxillofacial Frailty Assessment Tools for Geriatric Population of Kerala.

AIM: The aim of this study is to translate the oral and maxillofacial frailty index (OMFI) into Malayalam, culturally adapt it, and test its reliability and validity in the Kerala geriatric population. MATERIALS AND METHODS: OMFI was translated, culturally adapted, and validated in Malayalam using a methodological and cross-sectional study design. The Malayalam version of OMFI underwent full linguistic validation and was tested on 200 patients at Amritakripa Hospital in Kalpetta. Principal component analysis with varimax rotation was used for exploratory factor analysis, and Cronbach's alpha was used to assess reliability. RESULTS: Two-hundred patients were recruited in this study. Participants ranged in age from 60 to 83 years; mean age was 68 years (SD: 15.21). In total 55.5% were male participants, and 30.5% were belonging to upper middle class as per the Kuppuswami scale. Only 12% of the participants were living alone. Kaiser-Meyer-Olkin was found to be 0.583, and Bartlett's test of sphericity was significant with a Chi-square test value of 1003.469. A principal axis factor analysis conducted on 20 items with orthogonal rotation (varimax). OMFI Malayalam version (5 items) had a good internal consistency (Cronbach's alpha = 0.751). Item-total correlations were reviewed for the items of OMFI. CONCLUSION: The OMFI Malayalam version demonstrated acceptable validity and reliability and can be used to screen the oral frailty of the geriatric population in Kerala. CLINICAL SIGNIFICANCE: As Kerala is having highest geriatric population in India, we need to assess the oral frailty burden of Kerala. This study provided the first measure to assess the oral frailty in elderly in Kerala.

Characterizing the Literature on Validity and Assessment Tool of Oral Frailty: A Systematic Scoping Review.

AIM: To systematically review all studies on assessment tools used to diagnose oral frailty in older adults. MATERIALS AND METHODS: A systematic search of PubMed, Google Scholar, and Scopus for articles yielded the tools published from January 2010 to January 2022. The search included articles reporting the use of the Oral Frailty risk assessment tool in older adults. A standardized protocol Joanna Briggs Institute (JBI) was used for data extraction. Flowchart and tables were used to demonstrate the results. RESULTS: A total of 19 studies were eligible out of 58 studies retrieved from selected databases. A total of three tools were structured for oral frailty assessment in older adults as follows: Oral and maxillofacial frailty index, oral frailty index-8 (OFI-8), and oral frailty checklist. The most critical parameter in assessing oral frailty was tongue pressure and dryness of the mouth. Other parameters for assessing oral frailty include the number of remaining teeth, oral diadochokinesis (ODK), masticatory performance, pain, dysphagia, taste alteration, use of dentures, bacterial count in the tongue coat, and presence or absence of periodontitis. The predictive validity of tools for differentiating high and low risks for oral frailty did not explore yet. CONCLUSION: There has not been much research into assessment tools for oral frailty. This comprehensive review of the available literature identified only three structured assessment tools as follows: The oral frailty checklist, the oral and maxillofacial frailty index, and OFI-8. The oral frailty checklist is the only available validated oral frailty assessment tool despite the disproportionately high prevalence of oral frailty and the projected increase. CLINICAL SIGNIFICANCE: Because an oral function examination for the elderly in their 60s is required to promote effective oral frailty countermeasures, an oral frailty assessment tool appropriate for the setting must be developed. This tool can be used as a population-wide standard of practice for screening oral frailty.