The temporal trend in frailty prevalence from 2011 to 2020 and disparities by equity factors among middle-aged and older people in China: a population-based study

TY - JOUR

T1 - The temporal trend in frailty prevalence from 2011 to 2020 and disparities by equity factors among middle-aged and older people in China: a population-based study

AU - Tang, Dongfeng

AU - Sheehan, Katie

AU - Goubar, Aicha

AU - Whitney, Julie

AU - O'Connell, Matt

N1 - Publisher Copyright: © 2025 The Author(s)

PY - 2025/3/6

Y1 - 2025/3/6

N2 - Background: Frailty is a challenging issue in China, however the prevalence of frailty across different population groups and whether this is changing over time remain unclear. Methods: Unstandardized and age-and sex-standardized prevalence of frailty (95 % confidence interval (95 % CI)) (Frailty Index) in the overall sample and for subgroups defined by equity factors (PROGRESS-Plus framework) from 2011 to 2020 were estimated using analyses of cross-sectional surveys in adults aged 45 and older participating in 5 waves (N = 16,784 to 18,904 across waves) of the China Health and Retirement Longitudinal Studies (CHARLS). Poisson regression was used to estimate prevalence ratios (PRs) of frailty by equity factors. Results: Unstandardized prevalence of frailty increased from 13.6 % (13.0 %-14.1 %) in 2011 to 18.7 % (18.1 %-19.3 %) in 2020.The standardized prevalence increased from 13.5 % (13.0 %-14.0 %) in 2011 to 16.3 % (15.8 %-16.9 %) in 2020. Frailty was consistently more prevalent at advanced ages, in rural areas, among females, as well as those less educated, without social engagement, and non-drinkers. Based on the Poisson regression model, non-north region, being female and older, lower education, having no social engagement, smoking and non-drinking, and higher household capital consumption were associated with higher prevalence. Conclusions: The prevalence of frailty among the middle-aged and older population in China has increased. There will be an associated health and social care cost. Interventions targeted at older adults, those in rural areas, women, as well as those less educated, having no social engagement, and non-drinkers to mitigate the negative effects of frailty may be warranted.

AB - Background: Frailty is a challenging issue in China, however the prevalence of frailty across different population groups and whether this is changing over time remain unclear. Methods: Unstandardized and age-and sex-standardized prevalence of frailty (95 % confidence interval (95 % CI)) (Frailty Index) in the overall sample and for subgroups defined by equity factors (PROGRESS-Plus framework) from 2011 to 2020 were estimated using analyses of cross-sectional surveys in adults aged 45 and older participating in 5 waves (N = 16,784 to 18,904 across waves) of the China Health and Retirement Longitudinal Studies (CHARLS). Poisson regression was used to estimate prevalence ratios (PRs) of frailty by equity factors. Results: Unstandardized prevalence of frailty increased from 13.6 % (13.0 %-14.1 %) in 2011 to 18.7 % (18.1 %-19.3 %) in 2020.The standardized prevalence increased from 13.5 % (13.0 %-14.0 %) in 2011 to 16.3 % (15.8 %-16.9 %) in 2020. Frailty was consistently more prevalent at advanced ages, in rural areas, among females, as well as those less educated, without social engagement, and non-drinkers. Based on the Poisson regression model, non-north region, being female and older, lower education, having no social engagement, smoking and non-drinking, and higher household capital consumption were associated with higher prevalence. Conclusions: The prevalence of frailty among the middle-aged and older population in China has increased. There will be an associated health and social care cost. Interventions targeted at older adults, those in rural areas, women, as well as those less educated, having no social engagement, and non-drinkers to mitigate the negative effects of frailty may be warranted.

KW - Healthy aging

KW - Frailty prevalence

KW - Cross-sectional

KW - China

UR - http://www.scopus.com/inward/record.url?scp=86000369553&partnerID=8YFLogxK

U2 - 10.1016/j.archger.2025.105822

DO - 10.1016/j.archger.2025.105822

M3 - Article

SN - 0167-4943

VL - 133

JO - ARCHIVES OF GERONTOLOGY AND GERIATRICS

JF - ARCHIVES OF GERONTOLOGY AND GERIATRICS

M1 - 105822

ER -