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Association of Frailty Status with Risk of Fall among Middle-Aged and Older Adults in China: A Nationally Representative Cohort Study

  • Original Research
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The journal of nutrition, health & aging

Abstract

Objectives

To investigate the association between frailty status and risk of fall among middle-aged and older Chinese people.

Design

A nationally representative prospective cohort study.

Setting and Participants

The study included 13,877 community-dwelling participants aged 45 years and above from the China Health and Retirement Longitudinal Study.

Methods

Frailty status was identified by the frailty index of health deficit accumulation. 34 variables at baseline were selected to calculate the frailty index. We excluded participants with incomplete information in construction of the frailty index at baseline. Falls were measured based on the respondents’ self-report. We used a logistic regression model to estimate the associations between the frailty status and risk of fall, and subgroup analyses and sensitivity analyses were further conducted.

Results

Of 13,877 participants, 2310 (16.6%) had falls during the observation period. 9027 (65.0%) participants were classified as robust, 4019 (29.0%) participants were classified as pre-frail, and 831 (6.0%) participants were classified as frail. Our results indicated per 0.01 increment in the frailty index was significantly associated with an increased risk of fall among middle-aged and older participants (OR: 1.52, 95%CI: 1.45–1.60). Such association was stronger when frailty was presented as a categorical variable, with an OR of 1.75 (95%CI: 1.59–1.93) for pre-frail and 3.04 (95%CI: 2.60–3.56) for frail. The area under the curve of the logistic model was 0.612 (95%CI: 0.600–0.625). Each 0.01 increment of the frailty index was association with a higher risk of fall among middle-aged (45–59years) participants (OR: 1.44, 95%CI: 1.29–1.60) than among older (≥60 years) participants (OR: 1.28, 95%CI: 1.16–1.41) at baseline (p=0.015 for interaction).

Conclusion

Frailty was significantly associated with an increased risk of fall among community-dwelling middle-aged and older people in China. It is necessary to screen and recognize frailty status to prevent falls among middle-aged and older adults.

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Acknowledgements

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Funding

Funding: None.

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Authors and Affiliations

  1. National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China

    Z. Lu, Y. Er, X. Deng, Y. Jin, Pengpeng Ye & Leilei Duan

  2. Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Y. Zhan

  3. School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China

    Y. Zhan

  4. School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia

    Pengpeng Ye

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Corresponding authors

Correspondence to Pengpeng Ye or Leilei Duan.

Ethics declarations

Statement of contribution: Study concept and design: Zhiming Lu, Xiao Deng, Leilei Duan; acquisition of data: Zhiming Lu, Yuliang Er, Xiao Deng; analysis and interpretation of data: Zhiming Lu, Ye Jin, Pengpeng Ye; drafting of the manuscript: Zhiming Lu, Yongle Zhan, Leilei Duan, Ye Jin; critical revision of the manuscript for important intellectual content: Leilei Duan, Pengpeng Ye, Yongle Zhan

Disclosure of Interest Statement: All authors have no declarations of interest to report.

Ethical Standards: All participants provided informed consent, and the protocol was approved by the Ethical Review Committee of Peking University.

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Lu, Z., Er, Y., Zhan, Y. et al. Association of Frailty Status with Risk of Fall among Middle-Aged and Older Adults in China: A Nationally Representative Cohort Study. J Nutr Health Aging 25, 985–992 (2021). https://doi.org/10.1007/s12603-021-1655-x

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  • DOI: https://doi.org/10.1007/s12603-021-1655-x

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