Abstract
BACKGROUND: There is limited research on the relationship between weight changes and the risk of frailty. This study aimed to investigate the association between weight changes throughout adulthood and frailty risk among middle-aged and older adults using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: We analyzed data from 12,009 adults aged 50 years and older from the 2007-2018 NHANES. Weighted logistic regression models were used to examine the associations between weight changes and frailty risk. In addition, restricted cubic splines (RCS) were applied to explore potential non-linear relationships. RESULTS: Over the course of adulthood, participants in the categories of maximum overweight, obese to non-obese, non-obese to obese, and stable obese demonstrated a significantly higher risk of frailty compared to the stable normal. The corresponding odds ratios were of 1.28 (95% CI: 1.07, 1.55), 2.50 (95% CI: 1.56, 4.01), 2.57 (95% CI: 2.15, 3.08), and 5.26 (95% CI: 4.03, 6.85), respectively. Additionally, weight loss of ≥ 2.5 kg within the 10 years prior to recruitment was associated with increased frailty risk, with an odds ratio of 1.24 (95% CI: 1.03, 1.50). CONCLUSION: This study found that patterns of weight change, including maximum overweight, obese to non-obese, non-obese to obese, and stable obesity, were significantly associated with an increased risk of frailty. Weight loss from middle to late adulthood and weight gain throughout adulthood were significant associated with an increased risk of frailty. These findings highlight the importance of maintaining a healthy body weight throughout adulthood.