Abstract: Oral frailty (OF) and social frailty (SF) are two frequently co-occurring and mutually reinforcing functional decline syndromes in older adults; yet, their intrinsic bidirectional mechanisms remain poorly understood. Drawing on the biopsychosocial model, this review analyzes the spiraling pathways through which OF and SF interact. In the physical-somatic pathway, chewing and swallowing difficulties lead to malnutrition and physical decline, depriving older adults of the capacity for out-of-home social participation. In the cognitive-emotional pathway, impaired oral appearance triggers stigma and social anxiety, shifting older adults from physical activity to active social withdrawal. In the behavioral-social pathway, shrinking social support undermines self-care motivation and disrupts healthcare engagement, which in turn accelerates oral functional deterioration. Malnutrition, depression, and polypharmacy act as potential moderating factors across these pathways, amplifying the cascading effects. Multidimensional screening should be integrated into comprehensive geriatric assessment, with multidisciplinary teams delivering interventions that restore physical function, rebuild psychological resilience, and reinforce social support. Such integrated approaches may help interrupt the synergistic decline of oral and social function and contribute to healthy aging.

Key words: Frailty, Oral frailty, Social frailty, Aged, Biopsychosocial model, Bidirectional mechanism, Integrated intervention, Review

摘要： 口腔衰弱（OF）与社会衰弱（SF）是老年群体中高度伴发且相互加剧的功能衰退综合征，但二者的内在双向驱动机制尚欠缺系统梳理。本文基于生物 - 心理 - 社会医学模式，分析了 OF 与 SF 的螺旋式衰退路径。在生理-躯体通路中，咀嚼吞咽障碍引发营养不良与体能衰退，剥夺老年人外出社交的躯体条件；在认知 - 情绪通路中，口腔形象受损诱发病耻感与社交焦虑，促使老年人由躯体受限演变为主动的社会隔离；在行为 - 社会通路中，社会支持萎缩导致自我照护动机下降与医疗脱节，反向加速口腔功能的失用性恶化。营养不良、抑郁与多重用药作为潜在调节因素，贯穿上述通路并放大衰退效应。跨维度联合筛查应纳入老年综合评估，依托多学科协作团队，在修复生理机能、重建心理防线与社会支持三个层面实施干预，阻断功能协同衰退，为促进健康老龄化提供科学依据。

关键词: 衰弱, 口腔衰弱, 社会衰弱, 老年人, 生物心理社会模式, 双向机制, 综合干预, 综述