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Background <p>Chronic gastrointestinal diseases (CGIDs) significantly affect global health, impairing both physical and mental well-being in the aging population. However, the relationship between CGIDs and the incidence of frailty and loneliness has not been fully explored.</p> Methods <p>This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) collected from 2011 to 2015, including 13,139 middle-aged and older participants (aged 45&#xa0;years and above). We assessed frailty using adapted phenotype criteria and loneliness through the Centre for Epidemiological Studies Depression Scale. Adjust logistic regression models, Cox regression, mediation and interaction analyses were employed to investigate the associations between CGIDs, loneliness, and frailty.</p> Results <p>Participants with CGIDs were associated with higher odds of frailty (OR = 1.59, 95% CI 1.36–1.87) at baseline. Over four years, CGIDs increased frailty risk (HR 1.22, 95% CI 1.04–1.43). The associations remained consistent across demographic and lifestyle subgroups. Loneliness mediated 12.26% of the total effect on incident frailty. No significant multiplicative (HR 0.97, 95% CI 0.70–1.33) or additive (RERI 0.08, 95% CI -0.44, 0.61) interactions were found between loneliness and CGIDs on incident frailty.</p> Conclusions <p>Our findings highlight loneliness as a significant mediator in the relationship between CGIDs and frailty, suggesting that interventions aimed at reducing loneliness could help mitigate frailty in affected individuals. This underscores the necessity for integrated care approaches that consider both physical and psychosocial factors in managing chronic conditions among the middle-aged and older adults.</p>

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Association between chronic gastrointestinal diseases and frailty: unveiling the mediating effect of loneliness

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月6日

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  • Yanwei Gan,
  • Shuangming Cai,
  • Shan Huang,
  • Huanshun Xiao,
  • Pei Tao,
  • Wenni Zhang

摘要

Background

Chronic gastrointestinal diseases (CGIDs) significantly affect global health, impairing both physical and mental well-being in the aging population. However, the relationship between CGIDs and the incidence of frailty and loneliness has not been fully explored.

Methods

This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS) collected from 2011 to 2015, including 13,139 middle-aged and older participants (aged 45 years and above). We assessed frailty using adapted phenotype criteria and loneliness through the Centre for Epidemiological Studies Depression Scale. Adjust logistic regression models, Cox regression, mediation and interaction analyses were employed to investigate the associations between CGIDs, loneliness, and frailty.

Results

Participants with CGIDs were associated with higher odds of frailty (OR = 1.59, 95% CI 1.36–1.87) at baseline. Over four years, CGIDs increased frailty risk (HR 1.22, 95% CI 1.04–1.43). The associations remained consistent across demographic and lifestyle subgroups. Loneliness mediated 12.26% of the total effect on incident frailty. No significant multiplicative (HR 0.97, 95% CI 0.70–1.33) or additive (RERI 0.08, 95% CI -0.44, 0.61) interactions were found between loneliness and CGIDs on incident frailty.

Conclusions

Our findings highlight loneliness as a significant mediator in the relationship between CGIDs and frailty, suggesting that interventions aimed at reducing loneliness could help mitigate frailty in affected individuals. This underscores the necessity for integrated care approaches that consider both physical and psychosocial factors in managing chronic conditions among the middle-aged and older adults.