Association of Reversible Frailty with All-Cause Mortality Risk in Community-Dwelling Older Adults and Analysis of Factors Affecting Frailty Reversal in Older Adults.

OBJECTIVES

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.

DESIGN

A combination of the nested case-control study and the prospective cohort study.

SETTING AND PARTICIPANTS

Pre-frail and frail older adults in the community follow-up cohort of Dalang Town, Dongguan City.

METHODS

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.

RESULTS

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.

CONCLUSIONS AND IMPLICATIONS

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.