Oral Frailty Assessment Tool: Instrument Development and Cross‐Sectional Validation Study

BACKGROUND: Oral frailty is widespread in older adults, which may gradually contribute to multiple adverse health outcomes. The current assessment tools may not comprehensively assess oral frailty; thus, a practical and feasible oral frailty scale is needed. OBJECTIVE: The study aimed to develop an oral frailty assessment tool and evaluate its psychometric properties. METHODS: Based on the Gilbert Multidimensional Conceptual Model of Oral Health, the items were generated through a literature review and Delphi expert consultants. For psychometric analysis, content, structure, concurrent, convergent and discriminant validity, and internal consistency reliability of the scale were assessed. Data were collected from a convenient sample of 372 Chinese older adults, and exploratory and confirmatory factor analyses were used. The diagnostic accuracy was conducted through receiver operating characteristic curve analysis. RESULTS: The newly developed scale consisted of five dimensions and 16 items. The content validity of the scale was 0.974, with 0.649 for concurrent validity, and the aggregation and differentiation validity were ideal. In addition, the samples were cross-validated by exploratory factor analysis and confirmatory factor analysis. The internal consistency reached 0.865, and the retest reliability was 0.940. Meanwhile, by comparing the diagnostic accuracy with the Oral Frailty Instrument-6, it was found that the cutoff value was 6.5. CONCLUSION: Oral Frailty Assessment Tool has acceptable content validity, structure validity and reliability, which can be used to guide the formulation and implementation of reasonable early intervention measures for oral frailty. A wider range of cultures and samples is needed to refine the scale, as validation was performed in only one culture.