Dong Yongfei, Wang Qianqian, Wang Xichao, Liu Can, Hussain Ibrar, Ma Hongmei, Lu Ke, Tang Zaixiang
The Second Affiliated Hospital of Soochow University, School of Public Health, Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, MOE Key Laboratory of Geriatric Diseases and Immunology, Suzhou Medical College of Soochow University, Suzhou, 215123, Jiangsu, P.R. China.
Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, P.R. China.
BMC Public Health. 2025 Jul 19;25(1):2513. doi: 10.1186/s12889-025-23713-0.
The number of residents at high altitude is high globally, yet few studies have been conducted on the association between altitude and incident frailty. We evaluated the prospective association and dose-response relationship between altitude and frailty among Chinese older adults.
We conducted a prospective cohort study using data from the China Health and Retirement Longitudinal Survey (CHARLS) from 2013 to 2018, enrolling 4065 participants aged ≥ 60 years at baseline. Frailty was assessed using a frailty index (FI) containing 29 health deficit indicators constructed. Cox proportional hazard regression and linear mixed model were used to analyze the association of altitude with frailty. Restricted Cubic Spline regression was used to assess the dose-response relationship between them.
After a median follow-up of 61 months, 1076 (26.5%) frailty events were documented, including 137 (32.2%) in the middle and 939 (25.8%) in the low altitude group. The FI in the middle altitude group was higher than that in the low altitude group at three waves (baseline = 2013, wave 1 = 2015, and wave 2 = 2018 years). The risk of incident frailty was increased by 24% (HR = 1.24, 95%CI: 1.03-1.48) in the middle altitude group compared to the low altitude group. The FI increased with increasing altitude. The RCS revealed an increased risk of developing frailty at altitudes above 2,000 m.
Exposure to high altitude is associated with an elevated risk of incident frailty. which suggested that early intervention with high-altitude residents can delay frailty.
全球高海拔地区居民数量众多，但关于海拔与衰弱发生率之间关联的研究较少。我们评估了中国老年人中海拔与衰弱之间的前瞻性关联及剂量反应关系。
我们利用2013年至2018年中国健康与养老追踪调查（CHARLS）的数据进行了一项前瞻性队列研究，基线时纳入4065名年龄≥60岁的参与者。使用包含29个健康缺陷指标构建的衰弱指数（FI）评估衰弱情况。采用Cox比例风险回归和线性混合模型分析海拔与衰弱的关联。使用受限立方样条回归评估两者之间的剂量反应关系。
中位随访61个月后，记录到1076例（26.5%）衰弱事件，其中中海拔组137例（32.2%），低海拔组939例（25.8%）。在三个时间点（基线=2013年，第1波=2015年，第2波=2018年），中海拔组的FI均高于低海拔组。与低海拔组相比，中海拔组发生衰弱的风险增加了24%（HR=1.24，95%CI：1.03-1.48）。FI随海拔升高而增加。受限立方样条分析显示，海拔高于2000米时发生衰弱的风险增加。
暴露于高海拔地区与衰弱发生率升高相关，这表明对高海拔地区居民进行早期干预可延缓衰弱。
