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Summary <p>This study explores the association between frailty trajectories and osteoporosis and hip fractures. Using data from two prospective longitudinal studies—the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), it finds that frailty status is significantly associated with both osteoporosis and hip fracture.</p> Background <p>Frailty is associated with a variety of chronic diseases, yet there is a lack of research on the association of frailty trajectories with osteoporosis and hip fracture.</p> Methods <p>This study used data from two prospective longitudinal cohorts: the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), with biennial follow-up from 2014 to 2018. A frailty index (FI) was used to measure frailty status, and group-based trajectory modeling was applied to identify four distinct frailty trajectories. Osteoporosis and hip fracture were defined based on self-reported physician diagnosis. Logistic regression models were used to examine associations between frailty trajectories and the two outcomes, with odds ratios (ORs) and 95% confidence intervals (CIs) reported.</p> Results <p>A total of 10,207 participants were included (6816 from HRS and 3391 from ELSA). Four groups of frailty trajectories were identified: the “stable robust trajectory” (<i>n</i> = 4949, 48.3%), the “pre-frailty trajectory” (<i>n</i> = 2717, 26.6%), the “moderate frailty trajectory” (<i>n</i> = 1937, 19.0%), and “severe frailty trajectory” (<i>n</i> = 624, 6.1%). Compared to the stable robust trajectory group, the association with osteoporosis was stronger in the multivariate-adjusted pre-frailty trajectory group (OR 1.91, 95% CI 1.69–2.15), the moderate frailty trajectory group (OR 3.02, 95% CI 2.6–3.52), and severe frailty trajectory group (OR 5.39, 95% CI 4.1–7.07), and in the moderate frailty trajectory (OR 2.55, 95% CI 1.68–3.87), and stronger association with hip fracture in the severe frailty trajectory group (OR 6.03, 95% CI 3.2–11.36).</p> Conclusion <p>These results suggest that frailty status is closely associated with the risk of osteoporosis and hip fracture, with poorer frailty status correlating with a higher risk of osteoporosis and hip fracture.</p>

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Association of frailty trajectories with osteoporosis and hip fracture in an older female population

  • 期刊论文

  • 发表日期：

    2026年4月9日

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  • Bin Zhang,
  • Jinguang Gu,
  • Ru Lu,
  • Yongli Dong

摘要

Summary

This study explores the association between frailty trajectories and osteoporosis and hip fractures. Using data from two prospective longitudinal studies—the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), it finds that frailty status is significantly associated with both osteoporosis and hip fracture.

Background

Frailty is associated with a variety of chronic diseases, yet there is a lack of research on the association of frailty trajectories with osteoporosis and hip fracture.

Methods

This study used data from two prospective longitudinal cohorts: the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA), with biennial follow-up from 2014 to 2018. A frailty index (FI) was used to measure frailty status, and group-based trajectory modeling was applied to identify four distinct frailty trajectories. Osteoporosis and hip fracture were defined based on self-reported physician diagnosis. Logistic regression models were used to examine associations between frailty trajectories and the two outcomes, with odds ratios (ORs) and 95% confidence intervals (CIs) reported.

Results

A total of 10,207 participants were included (6816 from HRS and 3391 from ELSA). Four groups of frailty trajectories were identified: the “stable robust trajectory” (n = 4949, 48.3%), the “pre-frailty trajectory” (n = 2717, 26.6%), the “moderate frailty trajectory” (n = 1937, 19.0%), and “severe frailty trajectory” (n = 624, 6.1%). Compared to the stable robust trajectory group, the association with osteoporosis was stronger in the multivariate-adjusted pre-frailty trajectory group (OR 1.91, 95% CI 1.69–2.15), the moderate frailty trajectory group (OR 3.02, 95% CI 2.6–3.52), and severe frailty trajectory group (OR 5.39, 95% CI 4.1–7.07), and in the moderate frailty trajectory (OR 2.55, 95% CI 1.68–3.87), and stronger association with hip fracture in the severe frailty trajectory group (OR 6.03, 95% CI 3.2–11.36).

Conclusion

These results suggest that frailty status is closely associated with the risk of osteoporosis and hip fracture, with poorer frailty status correlating with a higher risk of osteoporosis and hip fracture.