To systematically evaluate the prevalence of oral frailty among community-dwelling elderly individuals, providing evidence-based support for improving oral health and enhancing the quality of life in this population.

A systematic search was conducted across nine databases, including CNKI, VIP, CBM, Wan Fang Data, Web of Science, PubMed, Embase, CINAHL, and The Cochrane Library, from the establishment of the database until June 13, 2024. Two researchers independently screened the literature and extracted relevant information, with data analysis performed using Stata 17.0.

A total of 26 studies met the inclusion criteria, encompassing 32 655 elderly participants. The prevalence of oral frailty (OF) in the community-dwelling elderly was 31.0% (95%CI: 22.6%-39.4%), while the prevalence of pre-oral frailty (pre-OF) was 55.0% (95%CI: 50.9%-59.0%). Subgroup analyses based on assessment tools, age, region, depression status, and living situation revealed the following: the prevalence using the Oral Frailty Index-5 (OFI-5) was 38.2% (95%CI: 35.6%-40.7%), the Oral Frailty Index-6 (OFI-6) was 18.5% (95%CI: 13.3%-23.7%), and the Oral Frailty Index-8 (OFI-8) was 47.2% (95%CI: 37.0%-57.4%); among elderly individuals living alone, the prevalence of OF was 22.1% (95%CI: 17.6%-26.6%) compared to 15.1%(95%CI: 12.4%-17.7%) for those not living alone; the prevalence of OF among depressed elderly individuals was 25.5%(95%CI: 6.6%-34.4%) versus 12.5% (95%CI: 8.1%-16.8%) for non-depressed individuals; the prevalence in Japan was 62.5% (95%CI: 61.1%-63.4%) compared to 44.3% (95%CI: 33.3%-55.4%) in China; and for the age group 60-69 years, the prevalence was 39.2% (95%CI: 35.1%-43.2%), while for those over 70 years, it was 54.6% (95%CI: 37.5%-71.1%).

The prevalence of OF among community-dwelling elderly individuals is notably high. Factors such as the assessment tool used (OFI-8), geographical location (Japan), age over 70, depression, living alone, and lower income are associated with a higher prevalence of OF. This indicates that healthcare professionals should prioritize oral health in the community elderly population, conduct early screenings, and implement relevant intervention measures to enhance the health status of elderly individuals in the community.