To investigate the relationship between oral frailty and physical frailty in elderly residents of Hanzhong communities, and to construct and validate a nomogram model that can predict the risk of physical frailty by using oral function indicators, so as to provide a practical tool for early screening in the community.

A cross-sectional study design was adopted. From August 2024 to April 2025, a total of 615 elderly individuals aged ≥60 years were recruited from 10 communities in Hanzhong, Shaanxi Province by multistage random sampling. Physical frailty was assessed by Chinese modified frailty phenotype (CMFP), and oral function was assessed by Chinese version of oral frailty index-8 (OFI-8) and its specific items. Variables were screened by LASSO regression, and then a multivariate logistic regression model and a nomogram were constructed. The discriminative ability and calibration degree of the model were evaluated by receiver operating characteristic curve area (AUC) and calibration curve.

Multivariable logistic regression analysis showed that advanced age (75-89 years: OR = 1.808, 95% CI: 1.084-3.015; ≥90 years: OR = 9.685, 95% CI: 3.320-28.251), diabetes (OR = 2.073, 95% CI: 1.187-3.619), masticatory difficulty (OR = 2.176, 95% CI: 1.226-3.861), dry mouth (OR = 1.769, 95% CI: 1.016-3.081), and denture use (OR = 1.512, 95% CI: 1.173-1.949) were independent risk factors for physical frailty, while higher body mass index (BMI) was a protective factor (18.5-24.0 kg/m²: OR = 0.249, 95% CI: 0.124-0.500; >24.0 kg/m²: OR = 0.309, 95% CI: 0.149-0.642). The nomogram model constructed based on these variables demonstrated moderate and stable predictive performance in both the training set (AUC = 0.760, 95% CI: 0.706-0.814) and the validation set (AUC = 0.746, 95% CI: 0.675-0.818). The Hosmer-Lemeshow test (P>0.05) and calibration curves indicated good model fit.

There is a significant association between oral frailty and physical frailty. The constructed nomogram integrates key predictors including advanced age, diabetes, BMI, masticatory difficulty, dry mouth, and denture use, providing an intuitive and practical tool for community healthcare workers to conduct initial screening for physical frailty risk. The findings suggest that in community-based health management for the elderly, in addition to focusing on traditional chronic diseases and nutritional indicators, attention should be paid to the assessment and intervention of masticatory function, oral wetness, and denture use, which may help in the early identification of high-risk individuals for frailty and the implementation of targeted measures.