JMIR Publications

ABSTRACT

Background:

Frailty is a dynamic geriatric syndrome associated with adverse health outcomes, yet its progression can be mitigated through targeted interventions.

Objective:

This study investigated predictors of frailty transitions in Chinese older adults, focusing on physical activity (PA) and physical function.

Methods:

Using data from the China Health and Retirement Longitudinal Study (CHARLS), we examined frailty (robust, pre-frail, frail) transitions between baseline data (collected in 2011) and follow-up data (collected in 2013) among 1,014 participants aged 65 and older. Frailty was assessed using the Physical Frailty Phenotype, and PA was measured using a modified International Physical Activity Questionnaire. Physical function was evaluated using the Short Physical Performance Battery (SPPB) and handgrip strength. Ordinal logistic regression models were used to examine the relationship between PA, physical function, and frailty transitions.

Results:

Results showed that higher PA levels and better physical function were associated with a reduced likelihood of worsening frailty or a greater chance of transitioning to a more robust state. Among robust individuals, increased handgrip strength predicted maintenance of robust state [Average marginal effects (AME) = 1.12%, p = 0.015]. Pre-frail individuals with higher vigorous PA [AME = 21.76%, p = 0.037] and handgrip strength [AME = 0.64%, p = 0.003] were more likely to transition to robust state. Frail individuals with increased low-intensity PA [AME = 22.48%, p = 0.038] and higher SPPB walking sub-scores [AME = 27.73%, p = 0.017] had a greater probability of improving to non-frailty.

Conclusions:

These findings highlight the importance of tailored interventions based on baseline frailty status. Promoting PA and improving physical function, particularly muscle strength and mobility function, may help delay or reverse frailty progression.