Zhang Xiaofeng, Yang Lingjia, Jin Zhenhua, Li Weili, Xiang Haiying, Wang Wenshi, Liang Feng
Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Shangtang road NO.158, Hangzhou, 310014, Zhejiang, China.
First People's Hospital of Xiaoshan District, Hangzhou, 311201, Zhejiang, China.
Sci Rep. 2025 Aug 4;15(1):28440. doi: 10.1038/s41598-025-14116-7.
Frailty has been linked to adverse health outcomes, but its relationship with stroke remains insufficiently understood in general populations. In this study, we examined the association between frailty and stroke using two nationally representative cohorts: the U.S. National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS). Frailty was assessed using a multidimensional frailty index, analyzed both continuously and by category. Weighted logistic regression and restricted cubic spline models were applied. We found that higher frailty index scores were associated with greater odds of stroke in both populations, independent of demographic and clinical risk factors. The association appeared remained consistent in multiple sensitivity and subgroup analyses. Each 0.1-unit increase in the frailty index was associated with a 2.90-fold and 1.78-fold higher odds of stroke in NHANES and CHARLS, respectively. While CHARLS provides prospective evidence supporting the temporal relationship between frailty and stroke, the cross-sectional nature of NHANES limits causal inference. Overall, these findings suggest that frailty may be a useful marker for identifying individuals at higher risk of stroke. Further research is needed to validate its predictive utility and to explore whether modifying frailty can help reduce stroke incidence, particularly in aging populations.
衰弱与不良健康结局相关，但在一般人群中，其与中风的关系仍未得到充分理解。在本研究中，我们使用两个具有全国代表性的队列——美国国家健康与营养检查调查（NHANES）和中国健康与养老追踪调查（CHARLS），研究了衰弱与中风之间的关联。使用多维衰弱指数评估衰弱情况，并对其进行连续分析和分类分析。应用加权逻辑回归和受限立方样条模型。我们发现，在两个人群中，较高的衰弱指数得分均与中风几率增加相关，且不受人口统计学和临床风险因素的影响。在多项敏感性分析和亚组分析中，这种关联似乎保持一致。在NHANES和CHARLS中，衰弱指数每增加0.1个单位，中风几率分别高出2.90倍和1.78倍。虽然CHARLS提供了支持衰弱与中风之间时间关系的前瞻性证据，但NHANES的横断面性质限制了因果推断。总体而言，这些发现表明，衰弱可能是识别中风高危个体的有用标志物。需要进一步研究来验证其预测效用，并探讨改善衰弱是否有助于降低中风发病率，尤其是在老年人群中。
