Background The proportion of older individuals is growing, and consequently, reduced physical performance and related conditions (i.e., sarcopenia and frailty) with age are a major challenge. Adverse oral health is associated with worse physical performance and functional limitations in older adults, but this evidence has been derived predominantly from cross-sectional studies. This study investigated the longitudinal relationship between oral health problems and poor physical function in a British cohort of older adults.

Methods The British Regional Heart Study (BRHS) is a socio-economically and geographically representative cohort of British men, aged 71–92 years in 2010–12. The cohort was followed-up in 2018 with data available at both time-points for questionnaires (n=930) and physical assessments (n=612). Physical assessments included objective measures of oral health (tooth count and periodontal disease) as well as measures of anthropometrics and physical performance. Questionnaires included measures of subjective oral health markers (dry mouth, self-rated oral health, difficulty eating, dental service use). The associations of oral health at baseline (2010–12) with poor physical performance (lowest tertile for grip strength and gait speed and highest tertile for chair stand speed) at follow-up were examined using logistic regression models. The models were minimally adjusted for age and physical function scores at baseline (for each respective model), and fully adjusted for additional confounding variables, including sociodemographic/behavioural factors (from questionnaires) and BMI.

Results Number of natural teeth at baseline (as a continuous variable) was associated with the low grip strength (≤28 kg; OR= 1.02; 95% CI:1.00, 1.05), slow chair stand speed (>14.91s; OR= 1.03; 95% CI:1.00, 1.05) and slow gait speed (≤0.76 m/s; OR= 1.03; 95% CI:1.01, 1.05) at follow-up (minimal adjustment). However, only associations between number of natural teeth and grip strength (OR= 1.03; 95% CI:1.01, 1.06) remained significant after full adjustment. There were associations between periodontal disease and slow gait speed that were attenuated on further adjustment. Being edentulous (no teeth; OR= 2.35; 95% CI:1.21, 4.55), having difficulty eating (OR= 3.03; 95% CI:1.30, 7.06), having fair/poor self-rated oral health (OR= 1.69; 95% CI:1.06, 2.70) and never visiting the dentist (OR= 2.40; 95% CI:1.09, 5.29) were associated with poor grip strength after full adjustment.

Conclusion This study extends previous findings demonstrating, longitudinally, that individuals with oral health problems have poorer physical function, specifically muscle strength, in later life. The findings suggest that objective and subjective measures of oral health could be early indicators of functional decline in older adults, warranting further investigation.