Abstract: Objective: To explore the heterogeneous trajectories of oral frailty and their influencing factors in older adults with stroke from the acute to recovery phase Methods: Through convenience sampling, 243 older stroke patients hospitalized in the neurology department of a tertiary grade A hospital in Wenzhou were recruited from August to December 2024. Oral frailty was assessed at admission and at 1, 3, and 6 months after discharge. Data were analyzed using a latent class growth model and multinomial Logistic regression. Results: A total of 218 patients completed the full survey. Three oral frailty trajectories from the acute to recovery phase were identified: "severe frailty-improving" (13.3%), "moderate frailty-improving" (46.8%), and "non-frail stable" (39.9%). Age, National Institutes of Health Stroke Scale score, comorbid chronic diseases, and nutritional status were associated with the trajectory of oral frailty changes in elderly stroke patients (P<0.05). Conclusion: Older adults with stroke exhibit three distinct oral frailty trajectories from the acute to recovery phase. Healthcare providers should implement stratified oral care interventions tailored to trajectory characteristics to improve oral function and overall outcomes.

Key words: oral frailty; stroke; older adults; trajectory