Objective: This study aims to examine the association between the frailty index (FI) and stroke risk among Chinese adults, describe the burden of stroke in China, and explore the causal role of FI in ischemic stroke through Mendelian randomization. Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS) included 13,473 participants aged 45 years and older without a history of stroke. Cox models, restricted cubic splines, and sensitivity analyses were employed to assess the association between the modified frailty index (mFI) and incident stroke. Additionally, data from the Global Burden of Disease (GBD) 2021 data report were utilized to describe stroke trends in China from 1990 to 2021. Two-sample Mendelian randomization was conducted to evaluate the causal effects of FI on ischemic stroke subtypes. Results: During a median follow-up period of approximately 7 years, 811 incident strokes were recorded. Each 0.1-point increase in mFI was associated with a 16% increase in stroke risk (HR = 1.16, 95% CI: 1.06–1.27), demonstrating a linear dose–response relationship. From 1990 to 2021, the proportion of ischemic stroke rose from 46.9% to 63.2%. Mendelian randomization analysis provided genetic evidence supporting a causal association between FI and ischemic stroke (OR = 1.191, 95% CI: 1.046–1.357), particularly driven by large-artery atherosclerotic (OR = 1.852) and small-vessel stroke (OR = 1.415), but not by cardioembolic stroke. Conclusions: A higher FI is associated with an increased risk of stroke among Chinese adults, with genetic evidence supporting a causal role in ischemic stroke. Therefore, FI may serve as a valuable addition to existing risk assessment tools.

This study investigated the relationship between sublingual microcirculatory tortuosity, frailty index scores, and endothelial glycocalyx blood biomarkers in individuals with chronic kidney disease (CKD). Sublingual microcirculatory videos were analyzed using a 0-4 tortuosity scoring scale. Plasma concentrations of syndecan-1 and soluble thrombomodulin were quantified using enzyme-linked immunosorbent assay (ELISA). Frailty status was assessed using a short-form frailty index questionnaire. The study included 44 patients (median age 53 years, IQR 45-64) attending a kidney transplant assessment clinic, with equal representation of males and females. The median frailty index was 0.19 (IQR: 0.15-0.30), with 63.5% of participants having an FI score < 0.25. Intraclass correlation coefficient (ICC) analysis demonstrated excellent inter-observer reliability for tortuosity scoring. Frailty index scores were significantly higher in participants with tortuosity scores of 3/4 compared to those with a score of 0. No significant differences were observed in syndecan-1 or soluble thrombomodulin levels across tortuosity scores. Ordinal logistic regression identified frailty index score as the only significant predictor of tortuosity, independent of age, dialysis type, or sex. Higher frailty index scores were associated with increased sublingual microcirculatory capillary tortuosity, though this relationship did not extend to endothelial glycocalyx biomarkers. These findings highlight the potential value of incorporating tortuosity assessment alongside density and perfusion measures in microcirculatory evaluation.

We aimed to examine the relationship between acute events and frailty trajectories of community-dwelling adults aged 60 and older. We included 3146 participants, aged 60+, from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). We considered all myocardial infarctions (MIs), lower respiratory tract infections (LRTIs) and falls that resulted in a hospitalization 5 years before to 12 years after SNAC-K baseline (2001-2004). Frailty was operationalized using a data-driven frailty index (FI), scored from 0 to 1. Linear quantile mixed models were used to examine the relationship between number and type of acute events and FI trajectories over a median follow-up of 11 years. Falls (n=690) were most common, followed by LRTIs (n=353) and MIs (n=205). Those with more acute events showed significantly higher frailty levels over time from age 75 to 95. The greatest differences in frailty trajectories by event count were observed at age 80, with increases between zero to one, one to two and two to three or more events of 0.04 (95% confidence interval [CI]=0.03-0.05), 0.08 (95% CI=0.05-0.11) and 0.09 (95% CI=0.05-0.13) FI units, respectively. Falls emerged as most deleterious, but there were also clear differences by MI and LRTI count after imputing frailty at death. Older adults who experience falls, LRTIs and MIs are more likely to sustain unfavourable frailty trajectories, with increasingly higher frailty levels with each additional acute event. Prevention, before age 75, should be optimized to avoid a vicious cycle of acute events and frailty progression as well as reduced lifespan.

Frailty as defined by the comprehensive geriatric assessment frailty index (CGA-FI) is associated with in-hospital complications and mortality in geriatric hip fracture patients, A retrospective cohort study.

Frailty and risk of incident psoriasis: Prospective UK Biobank evidence with inflammatory, genetic, and proteomic analyses.

Impact of Cumulative Deficits Frailty Index on Outcomes in Lung Transplant Recipients Aged over 70 Years

Loneliness trajectories and long-term frailty in the english longitudinal study of ageing: The mediating role of depression.

Fried Frailty Index Does Not Accurately Predict Outcomes in Heart Transplant Recipients

The Impact of Frailty on Mechanical Complications Following Lumbar Fusion Surgery: A Propensity Score-matched Analysis.

Modified Frailty Index and outcomes after liver transplantation: A multicenter cohort study.

Early coronary angiography and survival in older adults with nstemi: a frailty-adjusted analysis

Redefining textbook outcome in contemporary colon surgery.

Gut microbial signature for frailty discrimination: a metagenomic meta-analysis of 28 independent cohorts.

Domains of senile asthenia syndrome in chronic heart failure: clinical and prognostic significance

The cumulative triglyceride-glucose-frailty index and risk of heart disease and stroke in early-stage cardiovascular-kidney-metabolic syndrome.

Frailty is a common condition in older hypertensive adults, and it is associated with an increased risk of adverse outcomes. Blood pressure variability (BPV) is an independent cardiovascular risk factor, but its relationship with frailty remains poorly understood, especially in outpatients. We aimed to investigate the association between short‑term 24‑hour BPV and frailty in a cohort of older hypertensive outpatients. In this cross‑sectional study, 184 hypertensive outpatients aged at least 75 years underwent frailty assessment using a 40‑item frailty accumulation index derived from comprehensive geriatric assessment and 24‑hour ambulatory BP monitoring (ABPM). The participants were categorized as nonfrail, prefrail, or frail, and short‑term BPV was quantified using multiple indices. Multiple regression analysis was used to identify associations between BPV and frailty status, and adjusted β estimates were reported. Mean (SD) age of the participants was 81.76 (4.32) years, and 68% were women. Of the entire group, 63 patients (34.2%) were nonfrail, 79 (42.9%) prefrail, and 42 (22.8%) frail. Frailty directly correlated with nocturnal diastolic BPV. In adjusted analyses, nocturnal diastolic BP was strongly associated with frailty (β = 0.076; P = 0.04), and systolic dipping showed a marked negative association with the frailty index (β = -0.17; P = 0.04). Nocturnal but not diurnal BPV is associated with frailty in older hypertensive outpatients. These findings support the potential clinical value of BPV in geriatric care as a noninvasive marker of physiological vulnerability, easy to obtain whenever ABPM is required for hypertension management. Further studies are needed to clarify causality and define the potential of BPV assessment and modulation in older patients.

Frailty is a multidimensional syndrome associated with adverse health outcomes in older adults and is commonly assessed using the self-reported Tilburg Frailty Indicator (TFI). Although the TFI was originally developed with physical, psychological, and social domains, evidence regarding its factor structure and measurement invariance across cultures remains mixed. To date, no large-scale study has examined the factorial validity and measurement invariance of the TFI in Saudi Arabia. A cross-sectional study was conducted among 428 community-dwelling Saudi adults aged ≥ 50years. Exploratory factor analysis (EFA) using tetrachoric correlations and unweighted least squares was performed to examine dimensionality. Confirmatory factor analysis (CFA) using weighted least squares mean, and variance adjustment (WLSMV) initially evaluated the original three-factor TFI structure, followed by additional models informed by EFA findings. Model stability was assessed using repeated 70/30 holdout cross-validation (200 iterations). Measurement invariance across gender, age group (50-64 vs. ≥ 65years), and marital status was examined using multiple-group CFA. Exploratory factor-retention analyses yielded partially divergent recommendations regarding dimensionality; however, comparative evaluation of competing solutions supported retention of a three-factor structure corresponding broadly to physical, psychological, and social frailty, explaining approximately 57% of the total variance. CFA indicated that an adapted three-factor model retaining all 15 items demonstrated excellent fit (CFI = 0.971, TLI = 0.966, RMSEA = 0.046) and outperformed the original specification (CFI = 0.926, TLI = 0.913, RMSEA = 0.073). A three-factor 14-item model excluding item Q6 showed comparable fit in sensitivity analyses. Cross-validation confirmed the robustness of the adapted 15-item model (median CFI = 1.00, median RMSEA = 0.00). Multiple-group CFA supported configural and threshold invariance across all examined subgroups. This study provides substantial evidence for the factorial validity, stability, and measurement invariance of an adapted three-factor 15-item TFI among community-dwelling older adults in Saudi Arabia. The findings support its use for frailty assessment and subgroup comparisons in Saudi and similar Middle Eastern populations, while highlighting the importance of culturally informed interpretation of frailty domains.

Periprosthetic femoral fractures (PFFs) account for up to 16% of all revision total hip arthroplasties (rTHAs) with one- and two-year mortality rates of 23.4 and 29.2%, respectively. Given the substantial clinical and financial burden, accurate preoperative risk assessment is essential. This study evaluated the predictive performance of the Five-Item Modified Frailty Index (mFI-5) and Risk Analysis Index (RAI) in patients undergoing surgery for PFs, aiming to improve preoperative assessment, inform surgical decision-making, and facilitate postoperative planning. A total of 824 patients at least 18 years old who underwent rTHA and/or open reduction internal fixation for PFF were identified in a national surgical database. The RAI and mFI-5 were calculated for each patient. Outcomes were major and minor complications, readmission, reoperation, non-home discharge, wound complications, venous thromboembolisms, and mortalities. Multivariable logistic regression models for each index-outcome were fitted, controlling for body mass index (BMI), operative time, procedure type, and smoking status. The ability of RAI and mFI-5 to predict postoperative outcomes was assessed using the area under the receiver operating curve (AUC) with DeLong's test used to compare differences between correlated AUCs. The RAI demonstrated significantly better predictive ability for mortality (AUC: 0.69 versus 0.53, P = 0.033) and non-home discharge (AUC: 0.71 versus 0.57, P < 0.001) compared with mFI-5. In adjusted models, RAI was significantly associated with mortality (OR [odds ratio] 1.08, 95% CI [confidence interval] 1.00 to 1.17, P = 0.040) and non-home discharge (OR 1.16, 95% CI 1.12 to 1.20, P < 0.001). The RAI was superior to the mFI-5 in predicting mortality and non-home discharge for patients undergoing surgical management of PPFs. Our findings support the implementation of RAI as a tool for preoperative risk stratification and may be impactful in surgical planning and counseling of geriatric orthopaedic patients and their families.

Frailty is highly prevalent among institutionalized older adults and may exacerbate vulnerability to pressure injuries. Despite its clinical relevance, the prognostic value of frailty for pressure injuries risk in nursing home residents remains insufficiently characterized. To determine the relationship between the FI, measured by the Frailty Index (FI), and the risk of pressure injuries in a population of very complex older adults living in Caribbean nursing homes. Data are from the KASEHPAD (Karukera Study on Aging in Nursing Homes) study, a prospective, longitudinal study conducted in six nursing homes in Martinique and Guadeloupe. The FI was calculated at baseline using a 31-item deficit accumulation model (score range: 0-1). The association between FI and pressure injuries risk was examined using logistic regression models, with and without adjustment for age and sex. The study sample consisted of 332 individuals with a mean age of 81.3 years (standard deviation, SD, 10.1), of whom 50.6% were male. The mean FI score was 0.28 ± 0.14. Among the participants, 111 (33.4%) were identified as having a moderate to high risk of pressure ulcers. FI was strongly correlated with pressure ulcer risk (r = - 0·64; p < 0·001). Participants with an FI > 0·40 had markedly increased odds of pressure injuries risk (age- and sex-adjusted OR 24·1, 95% CI 11·7-52·7, p < 0.001). Frailty was independently and strongly associated with pressure injuries risk among nursing home residents. Routine assessment of frailty should be integrated into geriatric care to facilitate early identification of individuals at heightened risk and to inform preventive interventions. Such an approach could substantially reduce the clinical and economic burden of pressure injuries in this vulnerable population.

Advanced cardiovascular-kidney-metabolic (CKM) syndrome (stages 3-4) signifies high-risk multi-organ dysfunction. The triglyceride-glucose-frailty index (TyG-FI), combining the TyG index with a frailty index, may better reflect both metabolic dysregulation and physiological decline than TyG-related indices alone. This study aimed to examine the association between TyG-FI and advanced CKM syndrome. This cross-sectional analysis used 2011-March 2020 National Health and Nutrition Examination Survey data from 6,960 adults with CKM syndrome. CKM syndrome stages 3 or 4 were considered advanced. Survey-weighted logistic regression and restricted cubic splines models were used to evaluate the relationship between TyG-FI and advanced CKM syndrome. The discriminatory power of TyG-FI was assessed using receiver operating characteristic (ROC) curves and compared to other TyG-related indices and FI. The highest TyG-FI quartile had significantly increased odds of advanced CKM syndrome (odds ratio: 10.32, 95% confidence intervals: 6.51-16.34) versus the lowest. A unit increase in TyG-FI corresponded to an odds ratio of 2.78 (95% confidence intervals: 2.39-3.22). Restricted cubic splines indicated a nonlinear dose-response association between TyG-FI and advanced CKM syndrome. Furthermore, ROC analysis demonstrated that TyG-FI had superior discriminatory ability (AUC = 0.796) compared to FI and all other TyG-related indices. TyG-FI shows a strong, dose-response association with advanced CKM syndrome and superior predictive performance, suggesting that a higher TyG-FI may increase the risk of advanced CKM syndrome.