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Abstract：
Frailty and activities of daily living (ADL) disability are common conditions among older population. Studies on the bidirectional relationship between frailty and ADL are limited. The current study examined the cross-sectional and longitudinal associations between frailty and ADL in middle-aged and older Chinese individuals.
The data was collected through the China Health and Retirement Longitudinal Study (CHARLS), conducted in 2011, 2013, and 2015, encompassing 17,284 individuals aged ≥45 years. We excluded individuals without follow-up data. 2,631 participants finished the baseline survey. The definition of ADL disability encompasses difficulty in engaging in either basic activities of daily living (BADL) or instrumental activities of daily living (IADL). Frailty was assessed according to the Fried criteria. Logistic regression was utilized to examine odds ratios (ORs) and 95% confidence intervals (CIs) for assessing the cross-sectional relationships between ADL with frailty at baseline. The prediction effects were explored using Cox proportional hazards analysis, testing hazard ratios (HRs) and 95%CIs.
In cross-sectional analysis, BADL [OR = 6.660 (4.519-9.815)], IADL [OR = 5.950 (4.490-7.866)], and ADL [OR = 5.658 (4.278-7.483)] exhibited significant associations with frailty; frailty demonstrated significant associations with BADL [OR = 6.741 (4.574-9.933)], IADL [OR = 6.042 (4.555-8.016)] and ADL [OR = 5.735 (4.333-7.591)]. In longitudinal analysis, IADL and ADL were significantly associated with frailty in participants without baseline frailty in the short-term period [IADL: HR = 1.971 (1.150-3.379), ADL: HR = 1.920 (1.146-3.215)], IADL exhibited a significant association with frailty in the long-term period [HR = 2.056 (1.085-3.895)]. There was no significant link observed between frailty and an elevated risk of disability onset in BADL, IADL and ADL during the short-term period. When considering the long-term perspective, frailty exhibited a significant association with an elevated risk of disability onset in BADL [HR= 1.820 (1.126-2.939)] and IADL [HR = 1.724 (1.103-2.694)].
In middle-aged and older adults, ADL and IADL disability predicted frailty after 2-year follow-up, IADL disability predicted frailty after 4-year follow-up. Moreover, frailty did not predict BADL, IADL and ADL disability after 2-year follow-up. However, frailty predicted BADL and IADL disability after 4-year follow-up.
The data was collected through the China Health and Retirement Longitudinal Study (CHARLS), conducted in 2011, 2013, and 2015, encompassing 17,284 individuals aged ≥45 years. We excluded individuals without follow-up data. 2,631 participants finished the baseline survey. The definition of ADL disability encompasses difficulty in engaging in either basic activities of daily living (BADL) or instrumental activities of daily living (IADL). Frailty was assessed according to the Fried criteria. Logistic regression was utilized to examine odds ratios (ORs) and 95% confidence intervals (CIs) for assessing the cross-sectional relationships between ADL with frailty at baseline. The prediction effects were explored using Cox proportional hazards analysis, testing hazard ratios (HRs) and 95%CIs.
In cross-sectional analysis, BADL [OR = 6.660 (4.519-9.815)], IADL [OR = 5.950 (4.490-7.866)], and ADL [OR = 5.658 (4.278-7.483)] exhibited significant associations with frailty; frailty demonstrated significant associations with BADL [OR = 6.741 (4.574-9.933)], IADL [OR = 6.042 (4.555-8.016)] and ADL [OR = 5.735 (4.333-7.591)]. In longitudinal analysis, IADL and ADL were significantly associated with frailty in participants without baseline frailty in the short-term period [IADL: HR = 1.971 (1.150-3.379), ADL: HR = 1.920 (1.146-3.215)], IADL exhibited a significant association with frailty in the long-term period [HR = 2.056 (1.085-3.895)]. There was no significant link observed between frailty and an elevated risk of disability onset in BADL, IADL and ADL during the short-term period. When considering the long-term perspective, frailty exhibited a significant association with an elevated risk of disability onset in BADL [HR= 1.820 (1.126-2.939)] and IADL [HR = 1.724 (1.103-2.694)].
In middle-aged and older adults, ADL and IADL disability predicted frailty after 2-year follow-up, IADL disability predicted frailty after 4-year follow-up. Moreover, frailty did not predict BADL, IADL and ADL disability after 2-year follow-up. However, frailty predicted BADL and IADL disability after 4-year follow-up.
摘要：
虚弱和日常生活活动（ADL）残疾是老年人群的常见病。关于虚弱与ADL之间双向关系的研究有限。本研究调查了中国中老年人的虚弱与ADL之间的横截面和纵向关联。
数据是通过中国健康与退休纵向研究(CHARLS)收集的，在2011年、2013年和2015年进行，包括17,284名年龄≥45岁的个体。我们排除了没有随访数据的个体。2631名参与者完成了基线调查。ADL残疾的定义包括参与日常生活的基本活动（BADL）或日常生活的工具性活动（IADL）的困难。根据Fried标准评估虚弱。使用Logistic回归检查比值比（ORs）和95％置信区间（CIs），以评估基线时ADL与虚弱之间的横截面关系。使用Cox比例风险分析探讨了预测效果，测试危险比(HR)和95CIs。
在横截面分析中，BADL[OR=6.660(4.519-9.815)]，IADL[OR=5.950(4.490-7.866)]，和ADL[OR=5.658（4.278-7.483）]表现出与脆弱的显着关联；脆弱表现出与BADL的显着关联[OR=6.741（4.574-9.933）]，IADL[OR=6.042(4.555-8.016)]和ADL[OR=5.735(4.333-7.591)]。在纵向分析中，IADL和ADL与短期无基线虚弱的参与者的虚弱显著相关[IADL:HR=1.971(1.150-3.379),ADL：HR=1.920（1.146-3.215）]，IADL在长期表现出与虚弱显著相关[HR=2.056(1.085-3.895)]。在BADL中，虚弱与残疾发作风险升高之间没有明显联系，短期IADL和ADL。当考虑到长远的观点时，在BADL[HR=1.820(1.126-2.939)]和IADL[HR=1.724(1.103-2.694)]中,虚弱与残疾发病风险升高显著相关。
在中老年人中，ADL和IADL残疾预测2年随访后的虚弱，IADL残疾预测4年随访后的虚弱。此外，脆弱没有预测到BADL,2年随访后IADL和ADL残疾。然而,衰弱可预测4年随访后的BADL和IADL残疾。
数据是通过中国健康与退休纵向研究(CHARLS)收集的，在2011年、2013年和2015年进行，包括17,284名年龄≥45岁的个体。我们排除了没有随访数据的个体。2631名参与者完成了基线调查。ADL残疾的定义包括参与日常生活的基本活动（BADL）或日常生活的工具性活动（IADL）的困难。根据Fried标准评估虚弱。使用Logistic回归检查比值比（ORs）和95％置信区间（CIs），以评估基线时ADL与虚弱之间的横截面关系。使用Cox比例风险分析探讨了预测效果，测试危险比(HR)和95CIs。
在横截面分析中，BADL[OR=6.660(4.519-9.815)]，IADL[OR=5.950(4.490-7.866)]，和ADL[OR=5.658（4.278-7.483）]表现出与脆弱的显着关联；脆弱表现出与BADL的显着关联[OR=6.741（4.574-9.933）]，IADL[OR=6.042(4.555-8.016)]和ADL[OR=5.735(4.333-7.591)]。在纵向分析中，IADL和ADL与短期无基线虚弱的参与者的虚弱显著相关[IADL:HR=1.971(1.150-3.379),ADL：HR=1.920（1.146-3.215）]，IADL在长期表现出与虚弱显著相关[HR=2.056(1.085-3.895)]。在BADL中，虚弱与残疾发作风险升高之间没有明显联系，短期IADL和ADL。当考虑到长远的观点时，在BADL[HR=1.820(1.126-2.939)]和IADL[HR=1.724(1.103-2.694)]中,虚弱与残疾发病风险升高显著相关。
在中老年人中，ADL和IADL残疾预测2年随访后的虚弱，IADL残疾预测4年随访后的虚弱。此外，脆弱没有预测到BADL,2年随访后IADL和ADL残疾。然而,衰弱可预测4年随访后的BADL和IADL残疾。
