Abstract：
BACKGROUND: In the context of the present global aging phenomenon, the senior population and pace of aging in China have emerged as prominent issues on the worldwide stage. Frailty, a complicated condition that is closely linked to the clinical syndrome of advancing age, poses a considerable health risk to older individuals. Frailty status was assessed by the frailty index (FI) ranging from 0 to 1, pre-frailty was defined as >0.10 to <0.25, and frailty was defined as ≥0.25. To look at the connection between modifiable risk factors and frailty progression among individuals in the pre-frailty population.
METHODS: Using pre-frailty patients as characterized by the 32-frailty index, the study focused on middle-aged and elderly persons from China and ultimately recruited 5,411 participants for analysis. The relationship between modifiable factors and changes in pre-frailty status throughout follow-up was investigated. Modifiable factors were body mass index (BMI), abdominal obesity, smoking status, alcohol use, and sleep status. We employed logistic regression to examine the relationships between modifiable risk factors and changes in pre-frailty status, as well as the associations between modifiable factors scores and the corresponding pre-frailty progression. Additionally, we generated the modifiable factors scores and examined how these related to modifications in the pre-frailty stage.
RESULTS: In this study, after a mean follow-up of 6 years, (OR = 0.59, 95%CI: 0.48-0.71) for BMI ≥ 25 kg/m2 and (OR = 0.74, 95%CI: 0.63-0.89) for concomitant abdominal obesity were significantly associated with lower reversal to a healthy state; (OR = 1.24, 95%CI:1.07-1.44) and (OR = 1.25, 95%CI: 1.10-1.42) for the group that negatively progressed further to frailty were significantly associated with increased frailty progression profile. Subsequently, investigation of modifiable factor scores and changes of pre-frailty status found that as scores increased further, frailty developed (OR = 1.12, 95%CI:1.05-1.18), with scores of 3 and 4 of (OR = 1.38, 95%CI: 1.08-1.77) and (OR = 1.52, 95%CI:1.09-2.14). Finally, we also performed a series of stratified analyses and found that rural unmarried men aged 45 to 60 years with less than a high school degree were more likely to develop a frailty state once they developed abdominal obesity.
CONCLUSIONS: In pre-frailty individuals, maintaining more favorable controllable variables considerably enhances the chance of return to normal and, conversely, increase the risk of progressing to the frailty.
METHODS: Using pre-frailty patients as characterized by the 32-frailty index, the study focused on middle-aged and elderly persons from China and ultimately recruited 5,411 participants for analysis. The relationship between modifiable factors and changes in pre-frailty status throughout follow-up was investigated. Modifiable factors were body mass index (BMI), abdominal obesity, smoking status, alcohol use, and sleep status. We employed logistic regression to examine the relationships between modifiable risk factors and changes in pre-frailty status, as well as the associations between modifiable factors scores and the corresponding pre-frailty progression. Additionally, we generated the modifiable factors scores and examined how these related to modifications in the pre-frailty stage.
RESULTS: In this study, after a mean follow-up of 6 years, (OR = 0.59, 95%CI: 0.48-0.71) for BMI ≥ 25 kg/m2 and (OR = 0.74, 95%CI: 0.63-0.89) for concomitant abdominal obesity were significantly associated with lower reversal to a healthy state; (OR = 1.24, 95%CI:1.07-1.44) and (OR = 1.25, 95%CI: 1.10-1.42) for the group that negatively progressed further to frailty were significantly associated with increased frailty progression profile. Subsequently, investigation of modifiable factor scores and changes of pre-frailty status found that as scores increased further, frailty developed (OR = 1.12, 95%CI:1.05-1.18), with scores of 3 and 4 of (OR = 1.38, 95%CI: 1.08-1.77) and (OR = 1.52, 95%CI:1.09-2.14). Finally, we also performed a series of stratified analyses and found that rural unmarried men aged 45 to 60 years with less than a high school degree were more likely to develop a frailty state once they developed abdominal obesity.
CONCLUSIONS: In pre-frailty individuals, maintaining more favorable controllable variables considerably enhances the chance of return to normal and, conversely, increase the risk of progressing to the frailty.
摘要：
背景：在当前全球老龄化现象的背景下，中国的老年人口和老龄化速度已经成为世界舞台上的突出问题。虚弱,一种与年龄增长的临床综合征密切相关的复杂疾病，对老年人构成相当大的健康风险。通过从0到1的虚弱指数（FI）评估虚弱状态，虚弱前定义为>0.10到<0.25，虚弱定义为≥0.25。目的观察衰弱前期中老年人群中可改变的危险因素与衰弱进展之间的联系。
方法：使用以32衰弱指数为特征的衰弱前期患者，本研究以中国中老年人为研究对象,最终招募5411名参与者进行分析.在整个随访过程中，研究了可改变因素与衰弱前状态变化之间的关系。可改变的因素是体重指数(BMI)，腹部肥胖，吸烟状况,酒精使用,和睡眠状态。我们采用逻辑回归来检验可改变的危险因素与衰弱前状态变化之间的关系，以及可修改因子得分与相应的衰弱前进展之间的关联。此外,我们生成了可修改因子的评分,并检查了这些因子与衰弱前阶段的修改之间的关系.
结果：在这项研究中，经过6年的平均随访，BMI≥25kg/m2（OR=0.59，95CI：0.48-0.71）和伴随腹型肥胖（OR=0.74，95CI：0.63-0.89）与向健康状态的较低逆转显着相关；（OR=1.24，95CI：1.07-1.44）和（OR=1.25，95CI：1.10-1.42）进一步向虚弱的进展显着相关。随后，对可修改的因子得分和虚弱前状态变化的调查发现，随着得分的进一步增加，发育脆弱(OR=1.12，95CI：1.05-1.18)，得分为3分和4分（OR=1.38，95CI：1.08-1.77）和（OR=1.52，95CI：1.09-2.14）。最后,我们还进行了一系列分层分析,发现年龄在45~60岁、高中以下的农村未婚男性一旦出现腹部肥胖,就更有可能出现虚弱状态.
结论：在虚弱的中老年人中，保持更有利的可控变量大大提高了恢复的机会，相反,降低了移动到脆弱的风险。
方法：使用以32衰弱指数为特征的衰弱前期患者，本研究以中国中老年人为研究对象,最终招募5411名参与者进行分析.在整个随访过程中，研究了可改变因素与衰弱前状态变化之间的关系。可改变的因素是体重指数(BMI)，腹部肥胖，吸烟状况,酒精使用,和睡眠状态。我们采用逻辑回归来检验可改变的危险因素与衰弱前状态变化之间的关系，以及可修改因子得分与相应的衰弱前进展之间的关联。此外,我们生成了可修改因子的评分,并检查了这些因子与衰弱前阶段的修改之间的关系.
结果：在这项研究中，经过6年的平均随访，BMI≥25kg/m2（OR=0.59，95CI：0.48-0.71）和伴随腹型肥胖（OR=0.74，95CI：0.63-0.89）与向健康状态的较低逆转显着相关；（OR=1.24，95CI：1.07-1.44）和（OR=1.25，95CI：1.10-1.42）进一步向虚弱的进展显着相关。随后，对可修改的因子得分和虚弱前状态变化的调查发现，随着得分的进一步增加，发育脆弱(OR=1.12，95CI：1.05-1.18)，得分为3分和4分（OR=1.38，95CI：1.08-1.77）和（OR=1.52，95CI：1.09-2.14）。最后,我们还进行了一系列分层分析,发现年龄在45~60岁、高中以下的农村未婚男性一旦出现腹部肥胖,就更有可能出现虚弱状态.
结论：在虚弱的中老年人中，保持更有利的可控变量大大提高了恢复的机会，相反,降低了移动到脆弱的风险。
