A survey on the trajectory of frailty in the middle-aged and elderly population in the Chengdu community: a retrospective observational study

成都市社区中老年人群衰弱轨迹调查:一项回顾性观察研究

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Abstract

BACKGROUND: Frailty, a prevalent clinical condition in the aging global population, increases the risk of disability, falls, and mortality. This study explores frailty trajectories and their influencing factors among middle-aged and elderly residents in Chengdu, China. MATERIALS AND METHODS: From May 2022 to April 2023, a face-to-face survey was conducted with residents of six Chengdu communities aged 50-89. Participants, all with normal cognitive function, reviewed their health conditions from age 30 to their current age. A frailty index (FI) comprising 45 parameters was calculated for each age segment. Latent class trajectory models (LCTM) were developed, and multinomial logistic regression was used to identify independent influencing factors. RESULTS: We collected 1007 valid responses, with 536 from individuals over 65 years old. Women completed 51.4% of the questionnaires. Based on the FI, 48.46% of participants had no frailty (FI = 0-0.1), 36.94% had mild frailty (FI = 0.1-0.2), and 14.60% had moderate frailty (FI > 0.2). The optimal LCTM for ages 31-70 identified four classes: Class1-high initial FI with rapid growth (n = 15, 2.80%), Class2-moderate growth (n = 215, 40.11%), Class3-slow growth (n = 187, 34.89%), and Class4-rapid growth (n = 119, 22.20%). Significant differences were observed between groups in terms of gender, service length, sleep quality, and number of chronic diseases. Class 1 had a higher proportion of females (86.67%), poorer sleep quality, and higher illness prevalence. Women were more likely to have fast-growing FI trajectories (OR = 2.25, 95% CI: 1.02-4.95), and alcohol consumption was linked to rapid FI increase (OR = 2.11, 95% CI: 1.06-4.20). Sleeping 7 + hours nightly before age 60 reduced the risk of fast-growing FI trajectories by 45% (OR = 0.55, 95% CI: 0.33-0.93). CONCLUSIONS: Over half of Chengdu's residents aged 50 and above show some degree of frailty. Women are more likely to experience fast-growing FI trajectories. Avoiding alcohol and ensuring adequate sleep are associated with a slower progression of frailty.

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