**5.2 Oral health and frailty**

Frailty is defined as a state, highly prevalent in older adults, of diminished functional reserves that lead to an increased vulnerability to stressors and adverse health results. It includes falls, reduced strength, mortality, growing dependency, a reduced ability to recover from tension situations and increased health care usage [54]. When taking care for frail people is important to be aware of seemingly minor issues. Clegg et al. [55] declared "an apparently small insult (e.g. a new drug; "minor" infection; or "minor" surgery) results in a dramatic and disproportionate change in health state: from independent to dependent; mobile to immobile; postural stability to falling; lucid to delirious".

As mentioned by Castrejón-Pérez et al. [56] the relation that lies between oral health and frailty is considerable and it comes from different pathways:


Hakeem et al. [54] study demonstrated that frailty index was associated with periodontal disease and tooth loss in older adults. Poor nutritional status contributes to

the progression of many morbidities involved in the complex and multiple etiology of frailty. This low nutritional intake leads older adults to an increased risk of oxidative stress, malnutrition, inflammation and frailty. There is a strong association between oral health and frailty. This last condition affects the oral status through loss of functions, which guide older adults to complications to take care of their oral hygiene and access to dental services [57].
