Xin Ye, Xinfeng Wang, Mingzheng Hu, Yingying Ouyang
{"title":"中老年人的虚弱和痴呆风险：来自三个前瞻性队列研究的证据","authors":"Xin Ye, Xinfeng Wang, Mingzheng Hu, Yingying Ouyang","doi":"10.1016/j.amepre.2025.108088","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Frailty and dementia are prevalent, interrelated conditions in aging populations; yet the temporal relationship between frailty progression and dementia risk remains underexplored. This study aimed to investigate how both baseline frailty and its subsequent changes over time are associated with the risk of incident dementia in three large prospective cohorts.</p><p><strong>Methods: </strong>This study analyzed data from 25,357 participants in three prospective cohorts: China Health and Retirement Longitudinal Study (CHARLS) 2011-2020, U.S. Health and Retirement Study (HRS) 2006-2020, and English Longitudinal Study of Ageing (ELSA) 2004-2023. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) between frailty and risks of dementia after adjusting for potential confounders. Analyses were conducted in 2025.</p><p><strong>Results: </strong>Across all three cohorts, participants who were pre-frail (HRs ranging from 1.13 to 1.17) or frail (HRs ranging from 1.37 to 1.54) at baseline had a significantly increased risk of dementia compared to their robust peers. This risk was most pronounced for those whose frailty status worsened over time; robust participants who transitioned to a frail state had increased risks of dementia (HRs ranging from 2.09 to 2.77). Participants who transitioned from pre-frail to frail showed significantly elevated risks of dementia (HR = 1.32). Participants with the upper and middle tertiles of total frailty index, and those in the upper tertile of change in frailty index, exhibited significantly increased risks of dementia.</p><p><strong>Conclusions: </strong>The findings from three large, multi-national cohorts consistently demonstrate a strong link between frailty progression and an increased risk of dementia particularly for those shifting from robust to frail state. This highlights that frailty is a globally relevant, modifiable target for dementia prevention, accentuating the necessity for proactive healthcare approaches to manage its onset and progression.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108088"},"PeriodicalIF":4.5000,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frailty and Risks of Dementia among Middle-aged and Older Adults: Evidence from Three Prospective Cohort Studies.\",\"authors\":\"Xin Ye, Xinfeng Wang, Mingzheng Hu, Yingying Ouyang\",\"doi\":\"10.1016/j.amepre.2025.108088\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Frailty and dementia are prevalent, interrelated conditions in aging populations; yet the temporal relationship between frailty progression and dementia risk remains underexplored. This study aimed to investigate how both baseline frailty and its subsequent changes over time are associated with the risk of incident dementia in three large prospective cohorts.</p><p><strong>Methods: </strong>This study analyzed data from 25,357 participants in three prospective cohorts: China Health and Retirement Longitudinal Study (CHARLS) 2011-2020, U.S. Health and Retirement Study (HRS) 2006-2020, and English Longitudinal Study of Ageing (ELSA) 2004-2023. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) between frailty and risks of dementia after adjusting for potential confounders. Analyses were conducted in 2025.</p><p><strong>Results: </strong>Across all three cohorts, participants who were pre-frail (HRs ranging from 1.13 to 1.17) or frail (HRs ranging from 1.37 to 1.54) at baseline had a significantly increased risk of dementia compared to their robust peers. This risk was most pronounced for those whose frailty status worsened over time; robust participants who transitioned to a frail state had increased risks of dementia (HRs ranging from 2.09 to 2.77). Participants who transitioned from pre-frail to frail showed significantly elevated risks of dementia (HR = 1.32). Participants with the upper and middle tertiles of total frailty index, and those in the upper tertile of change in frailty index, exhibited significantly increased risks of dementia.</p><p><strong>Conclusions: </strong>The findings from three large, multi-national cohorts consistently demonstrate a strong link between frailty progression and an increased risk of dementia particularly for those shifting from robust to frail state. This highlights that frailty is a globally relevant, modifiable target for dementia prevention, accentuating the necessity for proactive healthcare approaches to manage its onset and progression.</p>\",\"PeriodicalId\":50805,\"journal\":{\"name\":\"American Journal of Preventive Medicine\",\"volume\":\" \",\"pages\":\"108088\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-09-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Preventive Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amepre.2025.108088\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.108088","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Frailty and Risks of Dementia among Middle-aged and Older Adults: Evidence from Three Prospective Cohort Studies.
Introduction: Frailty and dementia are prevalent, interrelated conditions in aging populations; yet the temporal relationship between frailty progression and dementia risk remains underexplored. This study aimed to investigate how both baseline frailty and its subsequent changes over time are associated with the risk of incident dementia in three large prospective cohorts.
Methods: This study analyzed data from 25,357 participants in three prospective cohorts: China Health and Retirement Longitudinal Study (CHARLS) 2011-2020, U.S. Health and Retirement Study (HRS) 2006-2020, and English Longitudinal Study of Ageing (ELSA) 2004-2023. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI) between frailty and risks of dementia after adjusting for potential confounders. Analyses were conducted in 2025.
Results: Across all three cohorts, participants who were pre-frail (HRs ranging from 1.13 to 1.17) or frail (HRs ranging from 1.37 to 1.54) at baseline had a significantly increased risk of dementia compared to their robust peers. This risk was most pronounced for those whose frailty status worsened over time; robust participants who transitioned to a frail state had increased risks of dementia (HRs ranging from 2.09 to 2.77). Participants who transitioned from pre-frail to frail showed significantly elevated risks of dementia (HR = 1.32). Participants with the upper and middle tertiles of total frailty index, and those in the upper tertile of change in frailty index, exhibited significantly increased risks of dementia.
Conclusions: The findings from three large, multi-national cohorts consistently demonstrate a strong link between frailty progression and an increased risk of dementia particularly for those shifting from robust to frail state. This highlights that frailty is a globally relevant, modifiable target for dementia prevention, accentuating the necessity for proactive healthcare approaches to manage its onset and progression.
期刊介绍：
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
