This systematic review and meta-analysis searched the Embase, PubMed, Cochrane Central Register of Controlled Trials, and Web of Science databases on May 18, 2023, for randomized controlled trials that examined the effectiveness of oral health interventions in improving oral frailty in community-dwelling older adults. We included 11 randomized controlled trials from four countries (734 participants). Interventions included oral exercise, oral exercise plus oral health education, and exercise plus oral health education and nutritional instruction. Oral exercise intervention significantly improved tongue-lip motor function "pa" pronunciation, tongue pressure, chewing function, and the maximum occlusal force (all P < 0.05). Participants in the exercise plus education and diet intervention group showed improved tongue pressure and maximum occlusal force (all P < 0.05). Our analysis suggests that oral exercise interventions improve oral motor function and muscle strength, which are key to delaying the progression of oral frailty, preventing subsequent adverse outcomes such as falls and frailty, and enhancing quality of life in community-dwelling older adults.

Background: Adverse childhood experiences (ACEs) have been associated with addictions such as substance use disorders. Few have examined ACEs on internet gaming disorder (IGD) as a newly established behavioral addiction, and the potential mediating role of insomnia remains unclear. We examined the associations between ACE number and types, IGD, and insomnia.Methods: Participants included 1, 231 Chinese university students (54.5% male; 56.9% aged 18–20 years) who had played internet games at least once in the previous month. ACEs were measured using the 10-item ACE questionnaire (yes/no). Symptoms of insomnia and IGD were measured using the Insomnia Severity Index and the 9-item Internet Gaming Disorder Scale–Short-Form, respectively. Multivariable regressions examined the associations, adjusting for sex, age, maternal and paternal educational attainment, monthly household income, smoking, and alcohol drinking. The mediating role of insomnia symptoms was explored.Results: The prevalence of ACEs≥1 was 40.0%. Childhood verbal abuse was the most prevalent (17.4%), followed by exposure to domestic violence (17.1%) and childhood physical abuse (15.5%). More ACE numbers showed an association with IGD symptoms (adjusted OR = 1.11, 95% CI 1.04, 1.17). Specifically, IGD symptoms were observed for childhood physical neglect, emotional neglect, sexual abuse, parental divorce or separation, and household substance abuse. Insomnia symptoms mediated the associations of ACE number and types with IGD symptoms (proportion of total effect mediated range 0.23–0.89).Conclusion: The number and specific types of ACEs showed associations with IGD mediated through insomnia. Screening of ACEs is recommended in future studies on IGD. Longitudinal data are warranted to determine the causality of the observed associations.