Frailty is a state of chronic inflammation, immunosenescence, physical weakness, and reduced resilience to stresses. It is the outcome of a high burden of the cell and tissue damage of aging, and all of the downstream consequences of that damage. Frailty is well known to correlate with an increased mortality risk, and the study here is one of many to demonstrate this point. We might look on frailty as a pointer to the most severe issues in aging, a list of those problems that should be addressed with the highest priority, if possible. Certainly both immune dysfunction and loss of muscle mass and strength are well studied, with numerous therapeutic research and development programs underway at various stages.
This study aimed to explore the association of 3-year change in frailty index (FI) with risk of all-cause mortality in an older Chinese population. We analyzed the data of 4,969 participants from the Chinese Longitudinal Healthy Longevity Survey. The primary outcome was all-cause mortality, which was a binary variable and defined as completed data and censored data. Cox proportional-hazard models were used to assess the association of 3-year change in FI with risk of all-cause mortality.
During a median of 4.08 years of follow-up, deaths were observed in 1,388 participants. We observed a 2.27-fold higher risk of all-cause mortality with increase in FI ≥ 0.045 versus change in FI < 0.015 (hazard ratio = 2.27). Similar significant associations were observed in the subgroup analyses by age, sex, and residence at baseline. Additionally, a nonlinear dose-response association of 3-year change in FI with risk of all-cause mortality was observed. In conclusion, excessive increase in FI was positively associated with an increased risk for all-cause mortality. Approaches to reducing FI may be of great significance in improving the health of older Chinese individuals.
