Chronic diseases and frailty transitions in community-dwelling older adults

Background: As global populations age, the prevalence of chronic diseases among older adults continues to rise. Although previous research has explored the relationship between chronic diseases and frailty, most studies used cross-sectional designs, limiting their ability to capture dynamic changes in frailty over time. Objectives: This study investigated the association between chronic diseases and frailty transitions among older adults while identifying factors influencing frailty worsening and improvement over time. Methods: Data were drawn from the Taiwan Longitudinal Study on Aging, a nationally representative survey. Frailty status was assessed based on the criteria of the Fried frailty phenotype. Multinomial logistic regression analysis was performed to examine the association between chronic diseases and frailty transitions, using data from 2007 To 2011. Community-dwelling older adults (> = 65 years) with cognitive intact (SPMSQ > = 8) were recruited. Results: Among the 1,283 participants, the prevalence of frailty was 8.7% in 2007. Among participants who were non-frail in 2007, by 2011, 10.2% had shown improvement, 41.2% remained stable, and 35.0% experienced worsening frailty. Results of multivariate nominal logistic regression indicated that individuals aged ≥ 75 years (RRR = 1.689, 95% CI:1.297–2.200, p <.001), females (RRR = 1.464, 95% CI:1.112–1.928, p =.007), and those with heart disease (RRR = 1.557, 1.137–2.134, p =.006) had a significantly higher risk of frailty worsening. Heart disease was also significantly associated with frailty improvement (RRR = 2.173, 1.439–3.283, p <.001). Gender-stratified analysis revealed that individuals aged ≥ 75 years had a higher risk of frailty worsening in both genders, while heart disease was associated with both frailty improvement (RRR = 2.136, 95% CI:1.229–3.711, p =.007) and worsening (RRR = 1.534, 95% CI:1.003–2.344, p =.048) in non-frail males, and heart disease (RRR = 2.101, 95% CI:1.136–3.885, p =.018) and musculoskeletal diseases (RRR = 2.095, 95% CI:1.151–3.812, p =.015) were significantly associated with frailty improvement in non-frail females. Conclusions: Older age, gender, and chronic diseases play pivotal roles in frailty transitions, with heart disease identified as an important factor for frailty improvement in both genders. Early frailty screening and sex-sensitive approaches may help mitigate frailty progression among community-dwelling older adults.