The Role of Physical Activity and Physical Function in Predicting Physical Frailty Transitions in Chinese Older Adults: Longitudinal Observational Study From CHARLS.

IF 4.8 Q1 GERIATRICS & GERONTOLOGY

JMIR Aging Pub Date : 2025-09-15 DOI:10.2196/75887

Ziwei Zeng, Chun Liang Hsu, Cindy Hui-Ping Sit, Stephen Heung-Sang Wong, Yijian Yang

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Abstract

Background: Frailty is a dynamic geriatric syndrome associated with adverse health outcomes, yet its progression can be mitigated through targeted interventions.

Objective: This study aimed to investigate predictors of frailty transitions in Chinese older adults, focusing on physical activity (PA) and physical function.

Methods: Using data from the China Health and Retirement Longitudinal Study (CHARLS), we examined transitions between frailty states (robust, prefrail, and frail) from 2011 (baseline) to 2013 (follow-up) among 1014 participants aged 65 years and older. The following outcomes were assessed, including frailty using the physical frailty phenotype, PA using a modified International Physical Activity Questionnaire, and physical function using the Short Physical Performance Battery (SPPB) and handgrip strength. Ordinal logistic regression models were used to examine the relationship between PA, physical function, and frailty transitions.

Results: Results showed that higher PA levels and better physical function reduced the likelihood of worsening frailty or increased the probability of transitioning to robustness. Key findings from the subgroup include: among robust individuals, greater handgrip strength predicted maintained robustness (average marginal effects [AME]=1.12%; P=.02); in prefrail individuals, higher vigorous PA (AME=21.76%; P=.04) and handgrip strength (AME=0.64%; P=.003) increased transitions to robustness; for frail individuals, increased low-intensity PA (AME =22.48%; P=.04) and higher SPPB walking subscores (AME=27.73%; P=.02) promoted improvement to nonfrailty.

Conclusions: These findings highlight the importance of tailored interventions based on baseline frailty status. Promoting PA and improving physical function, particularly muscle strength and mobility function, may help delay or reverse frailty progression.

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身体活动和身体功能在预测中国老年人身体虚弱转变中的作用：CHARLS的纵向观察研究。

背景：虚弱是一种与不良健康结果相关的动态老年综合征，但其进展可以通过有针对性的干预措施得到缓解。目的：本研究旨在探讨中国老年人虚弱转变的预测因素，重点关注体力活动（PA）和身体功能。方法：利用中国健康与退休纵向研究（CHARLS）的数据，研究了2011年（基线）至2013年（随访）1014名年龄在65岁及以上的参与者的虚弱状态（健壮、虚弱和虚弱）之间的转变。评估了以下结果，包括使用身体虚弱表型的虚弱，使用改进的国际身体活动问卷的PA，以及使用短物理性能电池（SPPB）和握力的身体功能。我们使用有序逻辑回归模型来检验PA、身体功能和虚弱过渡之间的关系。结果：结果表明，较高的PA水平和更好的身体功能降低了虚弱恶化的可能性或增加了向健壮过渡的可能性。亚组的主要发现包括：在健壮的个体中，更大的握力预示着保持健壮（平均边际效应[AME]=1.12%； P= 0.02）；在体弱前个体中，较高的有力PA （AME=21.76%， P= 0.04）和握力（AME=0.64%， P= 0.003）增加了向健壮性的过渡；对于体弱个体，增加低强度PA （AME= 22.48%； P= 0.04）和提高SPPB步行评分（AME=27.73%； P= 0.02）促进改善至非体弱。结论：这些发现强调了基于基线虚弱状态量身定制干预措施的重要性。促进PA和改善身体功能，特别是肌肉力量和活动功能，可能有助于延缓或逆转虚弱的进展。

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