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Background <p>Although the impact of baseline frailty status on chronic disease risks has been well-established, evidence on the associations between changes in frailty status and the incidence of new-onset chronic diseases remains limited.</p> Methods <p>A retrospective study of prospectively collected data from the China Health and Retirement Longitudinal Study (CHARLS) including 7 021 adults aged 45 years or older. Frailty status was evaluated by the Rockwood frailty index and classified as robust, pre-frail, or frail. Changes in frailty status were assessed by frailty status at baseline (2011) and the second survey (2013). All chronic diseases were identified by self-reported physician diagnosis. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs.</p> Results <p>Compared to stable robust participants, robust participants who progressed to pre-frail/frail status had significantly elevated risks of all chronic diseases studied (HRs: 1.38–2.73), except for cancer (HR: 1.32; 95% CI: 0.83–2.12). Pre-frail participants who progressed to frail status showed only significantly elevated risks of hypertension (HR: 1.34; 95% CI: 1.01–1.77) and memory disease (HR: 1.63; 95% CI: 1.11–2.39) compared to stable pre-frail participants. In contrast, pre-frail participants who recovered to robust status demonstrated decreased risks of CVD, heart disease, stroke, kidney disease, digestive disease, psychiatric disease, and memory disease than stable pre-frail participants (HRs: 0.39–0.66). Similarly, frail participants who recovered to robust/pre-frail status also showed decreased risks of CVD, stroke, diabetes, psychiatric disease, and memory disease compared to stable frail participants (HRs: 0.39–0.73).</p> Conclusions <p>Different changes in frailty status are associated with different risks of new-onset chronic diseases. Progression of frailty status increases risks of almost all chronic diseases, while recovery of frailty status decreases risks of approximately half of all chronic diseases.</p>

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Associations of changes in frailty with multiple chronic diseases in middle aged and elderly adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月15日

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  • Tianci Yao,
  • Chengyun Liu,
  • Kun Wang,
  • Guangyu Gao,
  • Xiaofang Zhao,
  • Haohui Fan,
  • Bei Song,
  • Ting Liu,
  • Xinyue Zhang,
  • Xueke Guang,
  • Hao Zhang,
  • Weilin Lu

摘要

Background

Although the impact of baseline frailty status on chronic disease risks has been well-established, evidence on the associations between changes in frailty status and the incidence of new-onset chronic diseases remains limited.

Methods

A retrospective study of prospectively collected data from the China Health and Retirement Longitudinal Study (CHARLS) including 7 021 adults aged 45 years or older. Frailty status was evaluated by the Rockwood frailty index and classified as robust, pre-frail, or frail. Changes in frailty status were assessed by frailty status at baseline (2011) and the second survey (2013). All chronic diseases were identified by self-reported physician diagnosis. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs.

Results

Compared to stable robust participants, robust participants who progressed to pre-frail/frail status had significantly elevated risks of all chronic diseases studied (HRs: 1.38–2.73), except for cancer (HR: 1.32; 95% CI: 0.83–2.12). Pre-frail participants who progressed to frail status showed only significantly elevated risks of hypertension (HR: 1.34; 95% CI: 1.01–1.77) and memory disease (HR: 1.63; 95% CI: 1.11–2.39) compared to stable pre-frail participants. In contrast, pre-frail participants who recovered to robust status demonstrated decreased risks of CVD, heart disease, stroke, kidney disease, digestive disease, psychiatric disease, and memory disease than stable pre-frail participants (HRs: 0.39–0.66). Similarly, frail participants who recovered to robust/pre-frail status also showed decreased risks of CVD, stroke, diabetes, psychiatric disease, and memory disease compared to stable frail participants (HRs: 0.39–0.73).

Conclusions

Different changes in frailty status are associated with different risks of new-onset chronic diseases. Progression of frailty status increases risks of almost all chronic diseases, while recovery of frailty status decreases risks of approximately half of all chronic diseases.