Abstract:

Objective This study examines the factors influencing oral frailty in the elderly community，develops a risk prediction model，and validates its efficacy，so as to provide references for identifying and preventing oral weakness in the elderly. Methods 556 elderly individuals from 4 communities were selected by convenience sampling from June to August 2024 in Zigong City Sichuan Province. They were randomly divided into a training group（383 cases）and a validation group（165 cases）. Data were collected by a general information questionnaire，Social Frailty Scale，Geriatric Depression Scale，and the Oral Frailty Index-8 screening tool. Logistic regression was used to determine the influencing factors，and R software was used to establish a nomogram model for predicting the risk of oral frailty. Bootstrap method and the validation group were used for internally validation of the model. Calibration curve was used to evaluate the prediction performance of the model. Results 548 valid questionnaires were collected. The final model variables included whether the age≥80 years，wearing removable dentures，reduced frequency of going out，brushing teeth less than twice a day，frequent dry mouth，increased difficulty in eating hard foods，and choking. The area under the receiver operating characteristic curve of the training group was 0.95（95%CI：0.93~0.97），and the best cutoff value was 0.687. The model achieved an accuracy of 87%，sensitivity of 91%，specificity of 85%，positive predictive value of 0.75，and negative predictive value of 0.95. The Hosmer-Lemeshow fitting test show that χ²=3.036，P=0.932，indicating a good model fit. Conclusion The oral frailty prediction model demonstrated a good discrimination，calibration，and clinical utility，which can provide a scientific basis for the prevention and early screening of oral frailty in the elderly.

Key words: Oral frailty, Aged, Prediction Model, Nomograms, Community Nursing

摘要：

目的 分析社区老年人口腔衰弱的影响因素，构建并验证其风险预测模型，为早期识别、预防老年人口腔衰弱提供参考。方法 于2024年6月—8月，采用便利抽样方法，选取四川省自贡市4个社区的556名老年人为调查对象，将其随机分为训练集（n=383）和验证集（n=165），采用一般资料调查表、社会衰弱量表、老年抑郁量表和口腔衰弱指数问卷收集资料。采用Logistic回归确定口腔衰弱的影响因素，运用R软件构建口腔衰弱风险预测模型并绘制列线图；采用加强Bootstrap法和验证集进行内部验证，采用受试者操作特征曲线下面积、校准曲线、决策曲线评价模型的预测性能。结果 回收有效问卷548份，年龄是否≥80岁、是否佩戴可拆卸义齿、外出频次是否减少、每日刷牙是否<2次、是否经常口干、是否进食硬食物更困难、进食是否有呛咳是社区老年人口腔衰弱的预测因子。训练集受试者操作特征曲线下面积为0.95（95%CI：0.93~0.97），最佳截断值为0.687、准确度为87%、灵敏度为91%、特异度为85%、阳性预测值为0.75、阴性预测值为0.95。Hosmer-Lemeshow拟合检验结果（χ²=3.036，P=0.932）显示模型拟合优度良好。结论 口腔衰弱风险预测模型具有良好的区分度、校准度和临床实用性，可为社区老年人口腔衰弱的预防和早期筛查提供参考。

关键词: 口腔衰弱, 老年人, 预测模型, 列线图, 社区护理