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Outline
To explore the relationship between the frailty index (FI) and the incidence of arthritis in middle-aged and elderly populations.
Using data from the China Health and Retirement Longitudinal Study (CHARLS) database, a total of 1 449 middle-aged and elderly individuals aged ≥45 years who were free of arthritis at baseline in 2011 were enrolled and followed up until 2020. The growth mixture model (GMM) was employed to identify the dynamic trajectories of the frailty index (FI) during the period from 2011 to 2015. Multivariable Cox regression analysis was performed to assess the associations of baseline FI, cumulative average FI, and FI trajectories with the incidence of new-onset arthritis. Restricted cubic spline(RCS) was used to examine the dose-response relationship, and Kaplan-Meier survival curves were generated.
During the follow-up period, 259 cases of new-onset arthritis were reported, with a cumulative incidence rate of 17.87%. The total number of follow-up person-years was 12 672.7 person-years. After adjusting for multiple covariates including age, sex, body mass index (BMI), history of chronic diseases, and laboratory test results, compared with the lowest baseline FI quartile, the highest baseline FI quartile was associated with a 185% increased risk of developing arthritis (HR=2.85, 95% CI: 1.85-4.40, P<0.001). In comparison with the lowest cumulative average FI quartile, the highest cumulative average FI quartile was linked to a 150% increased risk of arthritis (HR=2.50, 95% CI: 1.67-3.74, P<0.001). Additionally, relative to the group with stable low FI levels, the high-level increasing FI group showed a 150% higher risk of arthritis onset (HR=2.50, 95% CI: 1.82-3.43, P<0.001). RCS analysis demonstrated a linear positive correlation between baseline FI and arthritis incidence (P-nonlinear=0.071), whereas a nonlinear relationship was found between cumulative average FI and arthritis occurrence (P-nonlinear=0.019). Kaplan-Meier curves confirmed that the cumulative risk differences in arthritis incidence among the three exposure groups were statistically significant (Log-rank test, all P<0.001).
Frailty is an independent risk factor for the development of arthritis in middle-aged and elderly individuals. For middle-aged and elderly individuals with high FI,attention should be paid to the prevention and screening of arthritis.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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