Abstract
OBJECTIVE: Our study aimed to investigate the relationship between early-life famine exposure and frailty risk in later life among middle-aged and older Chinese adults, advocating for targeted early-life nutritional interventions. METHOD: Based on the data from the fourth wave (2017-2018) of the China Health and Retirement Longitudinal Study, participants involved were further classified into four groups according to their birth year: fetal, preschool, school-aged, and non-exposed groups. Multiple logistic regression was adopted to examine the relationship between famine exposure and frailty. This relationship was further examined among populations of different sexes and famine severity levels. Sensitivity analysis additionally confirmed the robustness of the results. RESULTS: A total of 4473 participants were included in our study, with 3353 experiencing famine exposure (74.96 %) and 308 (6.89 %) being frail. The multiple logistic regression demonstrated a significant association between famine exposure and frailty in Model 2 after adjusting for all covariates. This relationship was also observed in different sexes and famine severity, except for females exposed to preschool famine and individuals exposed to mild preschool famine. CONCLUSIONS: Our research has demonstrated that early-life famine exposure probably increases the risk of frailty in adulthood. Therefore, powerful public health policies to improve people's growing environment and their nutritional conditions in early life can significantly lower the risk of adverse outcomes.