Hu Meili, Si Jiacheng, Wang Jiayi
Department of Gynecology, Baoding Maternal and Child Health Care Hospital, Baoding, China.
School of Sociology and Population Studies, Renmin University of China, Beijing, China.
J Adv Nurs. 2025 May;81(5):2402-2417. doi: 10.1111/jan.16422. Epub 2024 Aug 29.
To identify the evidence of gender disparities in frailty and explore the factors contributing to male-female differences.
A longitudinal study.
A total of 24,429 older adults (60+) were enrolled. Frailty was assessed by frailty index and frailty risk based on Rockwood's cumulative deficit frailty index. OLS and logistic regression models were conducted, with Oaxaca-Blinder and Fairlie decomposition methods to further analyse the factors contributing to gender disparities in frailty.
The paper used four waves of the China Health and Retirement Longitudinal Study from 2011 to 2018, a nationwide survey organised by the National Development Institute of Peking University.
Women had higher frailty status than men, with more pronounced increases. Among the factors, education has the most significant association with frailty gender disparities. The contribution of individual characteristics, particularly education, to gender disparities in frailty appeared to diminish over time, while the contribution of family and regional factors remained relatively stable, and the contribution of institutions was deemed inadequate.
The frailty in Chinese older adults is generally on the rise with continuously expanded gender disparities. It is crucial to consider the contributing factors to frailty in older adults for effective prevention and intervention strategies. Additional gender-specific geriatric care policies are needed in order to address gender inequality in health.
The findings of this study highlight the prevalence of increasing gender disparities in frailty and identify that the level of education, per capita annual household income as well as marital status are the most significant factors contributing to the gender gap. Those findings provide policy implications for healthcare nursing service from a gender-specific perspective in order to achieve health equity.
This study has adhered to the STROBE guideline.
No Patient or Public Contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY: This study provided implications on gender-specific geriatric care nursing services. The study highlighted the importance of focusing on frailty and its gender disparities in geriatric clinical nursing.
确定衰弱方面性别差异的证据，并探讨导致男女差异的因素。
一项纵向研究。
共纳入24429名60岁及以上的老年人。基于罗克伍德累积缺陷衰弱指数，通过衰弱指数和衰弱风险评估衰弱情况。进行了普通最小二乘法（OLS）和逻辑回归模型分析，并采用瓦哈卡-布林德（Oaxaca-Blinder）和费尔利（Fairlie）分解方法进一步分析导致衰弱性别差异的因素。
本文使用了2011年至2018年北京大学国家发展研究院组织的全国性调查——中国健康与养老追踪调查（CHARLS）的四轮数据。
女性的衰弱状况高于男性，且增长更为明显。在这些因素中，教育与衰弱性别差异的关联最为显著。个体特征，尤其是教育，对衰弱性别差异的贡献似乎随着时间的推移而减少，而家庭和地区因素的贡献相对稳定，机构因素的贡献则被认为不足。
中国老年人的衰弱总体呈上升趋势，性别差异不断扩大。考虑老年人衰弱的影响因素对于制定有效的预防和干预策略至关重要。需要额外的针对性别差异的老年护理政策，以解决健康方面的性别不平等问题。
本研究结果凸显了衰弱方面性别差异不断扩大的普遍性，并确定教育水平、家庭人均年收入以及婚姻状况是导致性别差距的最重要因素。这些发现从性别特定角度为医疗护理服务提供了政策启示，以实现健康公平。
本研究遵循了加强流行病学观察性研究报告质量（STROBE）指南。
无患者或公众贡献。本文对更广泛的全球临床社区有何贡献：本研究为针对性别差异的老年护理服务提供了启示。该研究强调了在老年临床护理中关注衰弱及其性别差异的重要性。
