Associations among self-reported oral health and intrinsic capacity domains in U.S. older adults: analysis from NHANES 2009-2014

Objective: The World Health Organization suggested a framework for intrinsic capacity (IC), a construct central to healthy aging, emphasizing five domains: cognition, vitality, locomotion, sensory function, and psychological well-being. Although oral health may influence these domains, it remains underexplored within the IC model. The present study was the first to comprehensively examine the associations among self-reported oral health and IC domains. Methods: We analyzed data from 845 adults aged ≥ 60 years from the 2009–2014 National Health and Nutrition Examination Survey (NHANES), representing approximately 9.10 million non-institutionalized U.S. individuals aged ≥ 60 years. Self-reported oral health indicators included symptoms, treatment history, and hygiene behaviors. IC domains were approximated using conceptually aligned variables available in NHANES. Results: Perceived gum disease and reported bone loss were inversely associated with unintentional weight loss (vitality) [odds ratio (OR) = 0.54; 95% confidence interval (CI):0.30–0.96 and OR = 0.56; 95%CI:0.35–0.90, respectively]. Regular flossing and visible tooth abnormalities were linked to lower (OR = 0.59; 95% CI:0.35–0.98) and increased risk of impaired locomotion (OR = 2.38; 95% CI:1.19–4.76), respectively. Reporting teeth becoming loose without injury, visible tooth abnormalities, and regular flossing were associated with cognitive impairment, but not in fully-adjusted models. No significant associations were observed for mouthwash use or having ever received treatment for gum disease. Conclusion: Self-reported oral health indicators were associated with several IC domains in older adults. Clinical relevance: These findings highlighted oral health as a relevant factor in functional aging and supported its inclusion in comprehensive assessments aimed at promoting autonomy and well-being in later life.