He Xiuping, Jing Wenyuan, Zhu Runze, Wang Qingze, Yang Jiacheng, Tang Xinming, Yang Ya, Che Kechun, Deng Jiayan, Yin Mingjuan, Ni Jindong
School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Dongguan, China; Precision Key Laboratory of Public Health, Guangdong Medical University, Dongguan, China.
School of Public Health, Shunde Women and Children's Hospital, Guangdong Medical University, Dongguan, China; Precision Key Laboratory of Public Health, Guangdong Medical University, Dongguan, China.
J Am Med Dir Assoc. 2025 May;26(5):105527. doi: 10.1016/j.jamda.2025.105527. Epub 2025 Mar 11.
Although frailty can increase the risk of premature death, whether reversal of frailty reduces the risk of premature death and what factors contribute to the reversal of frailty have not been thoroughly investigated. This study aimed to investigate the link between frailty reversal and all-cause mortality and the factors affecting frailty reversal.
A combination of the nested case-control study and the prospective cohort study.
Pre-frail and frail older adults in the community follow-up cohort of Dalang Town, Dongguan City.
We used a nested case-control study to enroll pre-frail and frail older individuals. After follow-up, we determined frailty-reversible and -irreversible groups. In a prospective cohort study with these 2 groups, all-cause death was set as the endpoint. We analyzed the link between frailty reversibility and all-cause mortality risk via incidence density ratios and Cox regression. Logistic regression was used to analyze factors affecting frailty reversibility.
There were 637 (33.3%) participants who had a reversal of frailty status. Compared with the irreversible group, the reversible group had a 53.9% lower risk of all-cause mortality. Age, illiteracy, cigarette smoking, and daily sedentary time were negatively associated with the reversal of frailty in older adults. Hemoglobin concentration and having an exercise habit were positively associated with frailty reversal.
The risk of all-cause mortality declined among older adults with a reversal of frailty. Hemoglobin concentration and exercise contributed to the reversal of frailty among older adults. In contrast, aging, long daily sedentary time, cigarette smoking, and illiteracy were risk factors for the reversal of frailty. These findings may provide better strategies for frailty intervention.
尽管衰弱会增加过早死亡的风险，但衰弱的逆转是否能降低过早死亡的风险以及哪些因素有助于衰弱的逆转尚未得到充分研究。本研究旨在探讨衰弱逆转与全因死亡率之间的联系以及影响衰弱逆转的因素。
巢式病例对照研究与前瞻性队列研究相结合。
东莞市大朗镇社区随访队列中的衰弱前期和衰弱老年人。
我们采用巢式病例对照研究纳入衰弱前期和衰弱的老年人。随访后，我们确定了可逆转衰弱组和不可逆转衰弱组。在对这两组进行的前瞻性队列研究中，将全因死亡设为终点。我们通过发病密度比和Cox回归分析了衰弱可逆性与全因死亡风险之间的联系。采用逻辑回归分析影响衰弱可逆性的因素。
有637名（33.3%）参与者的衰弱状态发生了逆转。与不可逆转组相比，可逆转组的全因死亡风险降低了53.9%。年龄、文盲、吸烟和每日久坐时间与老年人衰弱的逆转呈负相关。血红蛋白浓度和有运动习惯与衰弱逆转呈正相关。
衰弱逆转的老年人全因死亡风险下降。血红蛋白浓度和运动有助于老年人衰弱的逆转。相比之下，衰老、每日久坐时间长、吸烟和文盲是衰弱逆转的危险因素。这些发现可能为衰弱干预提供更好的策略。
