A risk prediction model for oral frailty in elderly patients with COPD was constructed based on the health ecology model

Background: Elderly patients with COPD often have oral health problems, such as dry oral mucosa, tooth loss, and gum disease. Dry oral mucosa makes it difficult for food to slide and chew in the mouth. Tooth loss or gum disease can affect chewing and occlusal functions, causing difficulty in swallowing during meals in elderly COPD patients and increasing the risk of dysphagia. Oral weakness is an independent risk factor for dysphagia in elderly patients with COPD. This study aims to explore the influencing factors of oral frailty in elderly patients with chronic obstructive pulmonary disease (COPD) and to construct a nomogram prediction model. Methods: From July 2025 to August 2025, convenience sampling was used to select 320 rows of elderly patients with chronic obstructive pulmonary disease in a ClassⅲGrade A hospital in Shandong Province as the research objects. Among them, 223 cases were included in the modeling group and 97 cases were included in the validation group. The oral frailty Index-8 was used to screen oral frailty, and a score ≥4 was defined as oral frailty. Multivariate Logistic regression was used to analyze the risk factors of oral frailty in elderly patients with chronic obstructive pulmonary disease. R software was used to establish a risk prediction model and draw a nomogram to visualize the model. ROC curve, Hosmer Lemeshow(H-L) test, calibration curve, and decision curve were used to verify the prediction effect of the model. Results: The incidence of oral frailty in elderly patients with chronic obstructive pulmonary disease was 92.5%. The influencing factors of oral frailty in elderly patients with chronic obstructive pulmonary disease were nutrition, the degree of dyspnea, and the type of chronic disease. The area under the ROC curve of the modeling group and the validation group was 0.97(95%CI: 0.94-1.00) and 0.92(95%CI: 0.83-1.00), respectively. The calibration curves of the two groups were well fitted (P=0.999, P=0.727). The decision curves of the two groups showed that the model had high clinical practicability. Conclusions: The nomogram prediction model constructed in this study has good efficacy, which is conducive to clinical nursing staff to early screen the risk of oral frailty in elderly patients with chronic pulmonary obstructive disease. Trial registration: Not applicable. Ethical Committee Approval： This study was approved by the Medical Ethics Review Committee of Jinzhou Medical University (Approval No. JZMULL2025269) on 17 March 2025