Towards an operational definition of oral frailty: A e-Delphi study

Karl G.H. Parisius*, Merel C. Verhoeff, Frank Lobbezoo, Limor Avivi-Arber, Joke Duyck, Hirohiko Hirano, Katsuya Iijima, Barbara Janssens, Anastassia Kossioni, Chia Shu Lin, Gerald McKenna, Frauke Müller, Martin Schimmel, Anita Visser, Yutaka Watanabe, Robbert J.J. Gobbens

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: Building upon our recently developed conceptual definition of oral frailty (the age-related functional decline of orofacial structures), this e-Delphi study aims to develop an operational definition of oral frailty by identifying its components. Methods: We used a modified e-Delphi study to reach a consensus among international experts on the components of oral frailty. Twelve out of fifteen invited experts in the field of gerodontology participated. Experts responded to three rounds of an online 5-point scale questionnaire of components to be included or excluded from the operational definition of oral frailty. After each round, scores and rationales were shared with all experts, after which they could revise their position. A consensus was reached when at least 70% of the experts agreed on whether or not a component should be included in the operational definition of oral frailty. Results: The experts achieved a high level of agreement (80 – 100%) on including eight components of oral frailty and excluding nineteen. The operational definition of oral frailty should include the following components: 1) difficulty eating hard or tough foods, 2) inability to chew all types of foods, 3) decreased ability to swallow solid foods, 4) decreased ability to swallow liquids, 5) overall poor swallowing function, 6) impaired tongue movement, 7) speech or phonatory disorders, and 8) hyposalivation or xerostomia. Conclusion: This e-Delphi study provided eight components that make up the operational definition of oral frailty. These components are the foundation for the next stage, which involves developing an oral frailty assessment tool.

Original languageEnglish
Article number105181
JournalArchives of Gerontology and Geriatrics
StatePublished - Feb 2024


  • International consensus
  • Modified e-Delphi study
  • Operational definition
  • Oral frailty
  • Oral function


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