HMN 2026: How New screening tool is adapted for US older adults to detect oral frailty

An international collaboration of researchers have successfully adapted a Japanese oral health screening tool for use among English-speaking older adults in the United States, potentially enabling earlier detection of oral frailty—an age-related decline in oral and pharyngeal function associated with physical frailty, malnutrition, and increased mortality risk.

The study, which was published in the journal Otolaryngology–Head and Neck Surgery, describes the rigorous cross-cultural adaptation of the Oral Frailty Index-8 (OFI-8), an eight-item patient-reported questionnaire originally developed in Japan to screen community-dwelling older adults for oral frailty risk. The team includes researchers from Weill Cornell Medicine, Michigan State University, the University of Iowa, New York University, the University of Wisconsin–Madison, and multiple institutions in Japan including the University of Tokyo.

The OFI-8 addresses eight key areas: difficulty eating hard foods, coughing when drinking liquids, denture use, dry mouth, reduced social outings, ability to chew hard foods, tooth brushing frequency, and dental visit frequency. A score of four or more points indicates a high risk of oral frailty and warrants further professional evaluation.

Previous research has shown that oral frailty, as measured by the original Japanese OFI-8, is associated with a 2.4-fold increased risk of physical frailty, 2.2-fold increased risk of sarcopenia, 2.3-fold increased risk of disability, and 2.2-fold increased risk of mortality.

The researchers note that while the adapted U.S.-English OFI-8 demonstrated strong comprehension and cultural appropriateness in this study, further validation research is needed to establish its reliability, validity, and appropriate cutoff scores for U.S. populations.

According to senior author Anaïs Rameau, MD, MSc, MPhil, MS, who is also currently on a Fulbright Scholar Award at the University of Tokyo and Fujita Health University, “This international collaboration has launched a long-term relationship in geriatric dysphagia among institutions.”

Dr. Rameau is also Chief of Dysphagia at the Sean Parker Institute for the Voice and Associate Professor and the Director of New Technologies in the Department of Otolaryngology–Head and Neck Surgery at Weill Cornell Medical College.

The content is provided for information purposes only.