中国膝关节骨关节炎与虚弱的双向关系：一项纵向研究。

IF 3.3 Q2 GERIATRICS & GERONTOLOGY

Journal of Frailty & Aging Pub Date : 2025-08-23 DOI:10.1016/j.tjfa.2025.100087

Ziwei Tian, Huimin Zhao, Yanping Zhai, Zhilan Yang

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引用次数: 0

摘要

背景：膝关节骨性关节炎是导致中老年人残疾和丧失独立性的常见疾病，并可能通过共享通路与虚弱相互作用。了解二者的双向关系对早期干预具有临床意义。本研究旨在调查中国中老年人膝关节骨关节炎与虚弱之间的关系。方法：本研究的数据来自中国健康与退休纵向研究（CHARLS）的三波（2011年基线、2013年随访和2015年随访）。共纳入3560名参与者。用虚弱指数评估虚弱程度。膝骨关节炎被定义为医生诊断的关节炎，伴有自我报告的膝关节疼痛。使用交叉滞后面板模型和随机截距交叉滞后面板模型发现纵向双向关系。结果：膝关节骨性关节炎与虚弱之间存在纵向双向关系，虚弱对继发膝关节骨性关节炎的影响更大（Wald χ²= 11.416,P < 0.001）。在人与人之间，患有膝骨关节炎的个体也倾向于有更高的虚弱风险（β= 0.454, P < 0.001）。在个人水平上，膝关节骨关节炎对虚弱的预测作用仅在长期内具有显著性（β=0.055, P < 0.05）。亚组分析表明，这种纵向双向关系在女性和低教育水平人群中尤为明显。结论：本研究揭示了中老年人膝关节骨关节炎与虚弱之间的纵向双向关系。特别是发现了虚弱在膝骨关节炎发展中的主导作用，以及随着时间的推移，膝骨关节炎的积累对虚弱的负面影响。这一结果表明，在老龄化社会中，针对脆弱的早期干预可能有助于中断膝关节骨关节炎的恶性循环，降低残疾的风险。它为公共卫生战略提供了科学依据。

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The bidirectional relationship between knee osteoarthritis and frailty in China: A longitudinal study.

Background: Knee osteoarthritis is a common disease that causes disability and loss of independence in middle-aged and older adults, and may interact with frailty through shared pathways. Understanding their bidirectional relationship is clinically meaningful for early intervention. This study aimed to investigate the associations between knee osteoarthritis and frailty among middle-aged and older adults in China.

Methods: The data for this study came from three waves (baseline 2011, follow-up 2013 and 2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3560 participants were included. Frailty was assessed with the Frailty Index. Knee osteoarthritis was defined as physician-diagnosed arthritis with self-reported knee pain. Longitudinal bidirectional relationships were found using cross-lagged panel models and random-intercept cross-lagged panel models.

Results: A longitudinal bidirectional relationship between knee osteoarthritis and frailty was observed, with a stronger effect of frailty on subsequent knee osteoarthritis (Wald χ² = 11.416, P < 0.001). At the between-person level, individuals with knee osteoarthritis also tend to have a higher risk of frailty (β= 0.454, P < 0.001). At the within-person level, the predictive effect of knee osteoarthritis on frailty was significant only in the long term (β=0.055, P < 0.05). Subgroup analyses showed that this longitudinal bidirectional relationship was particularly strong among females as well as those with low education levels.

Conclusions: This study reveals a longitudinal bidirectional relationship between knee osteoarthritis and frailty in middle-aged and older adults. In particular, the dominant role of frailty in the development of knee osteoarthritis was found, as well as the negative impact of knee osteoarthritis accumulation on frailty over time. This result suggests that targeting frailty early interventions in an ageing society may help to interrupt the vicious cycle of knee osteoarthritis and reduce the risk of disability. It provides a scientific basis for public health strategies.

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来源期刊

Journal of Frailty & Aging GERIATRICS & GERONTOLOGY-

CiteScore

5.90

自引率

7.70%

发文量

期刊介绍： The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).