Zhu Xinyu, Huang Yikeng, Liang Li, Zhang Xinyu, Zhang Zixuan, Jiang Yujin, Wu Xiaoqian, Li Chenxin, Zheng Zhi, Bao Zhangli, Zou Wenjun, Zhao Shuzhi
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China.
J Gerontol A Biol Sci Med Sci. 2025 Feb 10;80(3). doi: 10.1093/gerona/glae300.
Both frailty and age-related macular degeneration (AMD) are related to aging and may share some common mechanisms. We aimed to examine the observational and causal association between frailty and the risk of AMD.
We included 320 810 participants free of AMD at baseline from the UK Biobank. Frailty phenotypes were defined according to 5 components: weight loss, exhaustion, slow gait speed, low grip strength, and low physical activity. Cox proportional hazard models were used to evaluate the association between frailty phenotype and the risk of AMD. A causal relationship between frailty phenotype and AMD was examined using 2-sample Mendelian randomization (MR) analysis.
During a median follow-up of 12.81 years, 7 222 AMD cases were documented. After adjusting for confounding factors, compared with nonfrail participants, both pre-frail and frail participants were significantly associated with an increased risk of AMD (hazard ratio [HR] 1.17, [95% confidence interval {CI}: 1.11, 1.23] for pre-frailty and HR 1.55 [95% CI: 1.40, 1.73] for frailty). With each 1-point increase in frailty phenotype score, the risk of AMD increased by 14%. Results from the 2-sample MR analysis supported the potential causal effect of frailty phenotype on AMD.
Our findings suggested that frailty assessment may help identify at-risk populations and serve as a potential strategy for early prevention and management of AMD.
衰弱和年龄相关性黄斑变性（AMD）均与衰老相关，且可能存在一些共同机制。我们旨在研究衰弱与AMD风险之间的观察性关联和因果关系。
我们纳入了英国生物银行中320810名基线时无AMD的参与者。根据体重减轻、疲惫、步态速度减慢、握力降低和身体活动量少这5个组成部分来定义衰弱表型。采用Cox比例风险模型评估衰弱表型与AMD风险之间的关联。使用两样本孟德尔随机化（MR）分析来检验衰弱表型与AMD之间的因果关系。
在中位随访12.81年期间，记录了7222例AMD病例。在调整混杂因素后，与非衰弱参与者相比，衰弱前期和衰弱参与者患AMD的风险均显著增加（衰弱前期的风险比[HR]为1.17，[95%置信区间{CI}：1.11，1.23]；衰弱的HR为1.55[95%CI：1.40，1.73]）。衰弱表型评分每增加1分，AMD风险增加14%。两样本MR分析结果支持衰弱表型对AMD的潜在因果效应。
我们的研究结果表明，衰弱评估可能有助于识别高危人群，并作为AMD早期预防和管理的潜在策略。
