*p-values were calculated using chi-square tests or the Mann-Whitney U test. All analyses applied sampling weights. Because of weighting and variable-specific missing data, the total N and weighted percentages may vary slightly and may not sum exactly to 100%.
Declarations
Author contributions
DHL: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. BRK: Investigation, Writing—original draft. MKJ: Validation, Writing—review & editing, Supervision. All authors read and approved the submitted version.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Ethical approval
This study used anonymized data from the 2023 Korean Elderly Survey conducted by the Korea Institute for Health and Social Affairs (KIHASA) under the Ministry of Health and Welfare, Republic of Korea. According to national research ethics guidelines, secondary analyses of de-identified public data are exempt from Institutional Review Board (IRB) review.
Consent to participate
Not applicable.
Consent to publication
Not applicable.
Availability of data and materials
Data from the 2023 Korean Elderly Survey are publicly available from the KIHASA data portal [https://data.kihasa.re.kr].
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature.Ageing Res Rev. 2011;10:430–9. [DOI] [PubMed]
Maher RL, Hanlon J, Hajjar ER. Clinical consequences of polypharmacy in elderly.Expert Opin Drug Saf. 2014;13:57–65. [DOI] [PubMed] [PMC]
Mangoni AA, Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: basic principles and practical applications.Br J Clin Pharmacol. 2004;57:6–14. [DOI] [PubMed] [PMC]
Davies LE, Spiers G, Kingston A, Todd A, Adamson J, Hanratty B. Adverse Outcomes of Polypharmacy in Older People: Systematic Review of Reviews.J Am Med Dir Assoc. 2020;21:181–7. [DOI] [PubMed]
Gnjidic D, Hilmer SN, Blyth FM, Naganathan V, Waite L, Seibel MJ, et al. Polypharmacy cutoff and outcomes: five or more medicines were used to identify community-dwelling older men at risk of different adverse outcomes.J Clin Epidemiol. 2012;65:989–95. [DOI] [PubMed]
Fried TR, O’Leary J, Towle V, Goldstein MK, Trentalange M, Martin DK. Health Outcomes Associated with Polypharmacy in Community-Dwelling Older Adults: A Systematic Review.J Am Geriatr Soc. 2014;62:2261–72. [DOI] [PubMed] [PMC]
Patterson SM, Cadogan CA, Kerse N, Cardwell CR, Bradley MC, Ryan C, et al. Interventions to improve the appropriate use of polypharmacy for older people.Cochrane Database Syst Rev. 2014:CD008165. [DOI] [PubMed]
Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people.Lancet. 2013;381:752–62. [DOI] [PubMed] [PMC]
Curhan SG, Shargorodsky J, Eavey R, Curhan GC. Analgesic Use and the Risk of Hearing Loss in Women.Am J Epidemiol. 2012;176:544–54. [DOI] [PubMed] [PMC]
Fraunfelder FW, Fraunfelder FT. Adverse ocular drug reactions recently identified by the National Registry of Drug-Induced Ocular Side Effects.Ophthalmology. 2004;111:1275–9. [DOI] [PubMed]
Wastesson JW, Morin L, Tan ECK, Johnell K. An update on the clinical consequences of polypharmacy in older adults: a narrative review.Expert Opin Drug Saf. 2018;17:1185–96. [DOI] [PubMed]
Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hyposalivation.Ther Clin Risk Manag. 2014;11:45–51. [DOI] [PubMed] [PMC]
Thomson WM. Dry mouth and older people.Aust Dent J. 2015;60:54–63. [DOI] [PubMed]
Sreebny LM, Schwartz SS. A reference guide to drugs and dry mouth–2nd edition.Gerodontology. 1997;14:33–47. [DOI] [PubMed]
Nederfors T, Isaksson R, Mörnstad H, Dahlöf C. Prevalence of perceived symptoms of dry mouth in an adult Swedish population--relation to age, sex and pharmacotherapy.Community Dent Oral Epidemiol. 1997;25:211–6. [DOI] [PubMed]
Sheiham A, Steele JG, Marcenes W, Lowe C, Finch S, Bates CJ, et al. The Relationship among Dental Status, Nutrient Intake, and Nutritional Status in Older People.J Dent Res. 2001;80:408–13. [DOI] [PubMed]
Sawada N, Takeuchi N, Ekuni D, Morita M. Effect of oral health status and oral function on malnutrition in community-dwelling older adult dental patients: A two-year prospective cohort study.Gerodontology. 2024;41:393–9. [DOI] [PubMed]
Nowjack-Raymer RE, Sheiham A. Association of Edentulism and Diet and Nutrition in US Adults.J Dent Res. 2003;82:123–6. [DOI] [PubMed]
Tsakos G, Watt RG, Rouxel PL, de Oliveira C, Demakakos P. Tooth Loss Associated with Physical and Cognitive Decline in Older Adults.J Am Geriatr Soc. 2015;63:91–9. [DOI] [PubMed]
Iwasaki M, Yoshihara A, Ito K, Sato M, Minagawa K, Muramatsu K, et al. Hyposalivation and dietary nutrient intake among community-based older Japanese.Geriatr Gerontol Int. 2016;16:500–7. [DOI] [PubMed]
Morley JE. Undernutrition in older adults.Fam Pract. 2012;29:i89–93. [DOI] [PubMed]
Volkert D, Beck AM, Cederholm T, Cereda E, Cruz-Jentoft A, Goisser S, et al. Management of Malnutrition in Older Patients-Current Approaches, Evidence and Open Questions.J Clin Med. 2019;8:974. [DOI] [PubMed] [PMC]
Reeve E, Shakib S, Hendrix I, Roberts MS, Wiese MD. The benefits and harms of deprescribing.Med J Aust. 2014;201:386–9. [DOI] [PubMed]
Pedersen A, Sørensen CE, Proctor GB, Carpenter GH. Salivary functions in mastication, taste and textural perception, swallowing and initial digestion.Oral Dis. 2018;24:1399–416. [DOI] [PubMed]
Watanabe D, Yoshida T, Watanabe Y, Yokoyama K, Yamada Y, Kikutani T, et al. Oral frailty is associated with mortality independently of physical and psychological frailty among older adults.Exp Gerontol. 2024;191:112446. [DOI] [PubMed]
Kang MG, Jung HW. Association Between Oral Health and Frailty in Older Korean Population: A Cross-Sectional Study.Clin Interv Aging. 2022;17:1863–72. [DOI] [PubMed] [PMC]
Yin Z, Fei Z, Qiu C, Brasher MS, Kraus VB, Zhao W, et al. Dietary diversity and cognitive function among elderly people: A population-based study.J Nutr Health Aging. 2017;21:1089–94. [DOI]
Cho HJ, Chae J, Yoon SH, Kim DS. Aging and the Prevalence of Polypharmacy and Hyper-Polypharmacy Among Older Adults in South Korea: A National Retrospective Study During 2010–2019.Front Pharmacol. 2022;13:866318. [DOI] [PubMed] [PMC]
Tanaka T, Takahashi K, Hirano H, Kikutani T, Watanabe Y, et al. Oral Frailty as a Risk Factor for Physical Frailty and Mortality in Community-Dwelling Elderly.Geriatr Gerontol Int. 2018;18:1661–7. [DOI]
Kusunoki H, Hasegawa Y, Nagasawa Y, Shojima K, Yamazaki H, Mori T, et al. Oral Frailty and Its Relationship with Physical Frailty in Older Adults: A Longitudinal Study Using the Oral Frailty Five-Item Checklist.Nutrients. 2025;17:17. [DOI]
Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.Lancet. 2020;396:413–46. [DOI] [PubMed] [PMC]
Lin FR, Yaffe K, Xia J, Xue QL, Harris TB, Purchase-Helzner E, et al.; Health ABC Study Group. Hearing Loss and Cognitive Decline in Older Adults.JAMA Intern Med. 2013;173:293–9. [DOI] [PubMed] [PMC]
Gutiérrez-Valencia M, Izquierdo M, Cesari M, Casas-Herrero Á, Inzitari M, Martínez-Velilla N, et al. The relationship between frailty and polypharmacy in older people: a systematic review.Age Ageing. 2018;84:1432–44. [DOI]
Vetrano DL, Palmer K, Marengoni A, Marzetti E, Lattanzio F, Roller-Wirnsberger R, et al.; Joint Action ADVANTAGE WP4 Group. Frailty and Multimorbidity: A Systematic Review and Meta-analysis.J Gerontol A Biol Sci Med Sci. 2019;74:659–66. [DOI] [PubMed]
Huang J, Zhang Y, Xv M, Sun L, Wang M. Association between oral health status and frailty in older adults: a systematic review and meta-analysis.Front Public Health. 2025;13:1514623. [DOI] [PubMed] [PMC]
Scott IA, Hilmer SN, Reeve E, Potter K, Le Couteur D, Rigby D, et al. Reducing inappropriate polypharmacy: the process of deprescribing.JAMA Intern Med. 2015;175:827–34. [DOI] [PubMed]
