Poor Research Articles

Socioeconomic differences in limited lung function: a cross-sectional study of middle-aged and older adults in Germany

BackgroundLimited lung function represents a serious health impairment. However, studies investigating social inequalities in limited lung function are rare. Thus, the current study investigates which socioeconomic groups are the most affected by overall limited lung function and severely limited lung function.MethodsData from the population-based German Aging Survey were used (N = 4472), with participants being 40 + years old. Lung function was assessed by the peak flow test. Education, income, and occupational prestige were used as socioeconomic indicators.ResultsWe found that overall limited lung function was highly prevalent across the whole sample, with about 33% (Women: 35%; Men: 30%) having overall limited lung function and 8% (Women: 7%; Men: 8%) having severely limited lung function. Socioeconomic differences in limited lung function emerged for all three indicators, education, income, and occupational prestige, in both men and women in single effect analyses. These differences persisted for occupational prestige and income when controlling for all indicators simultaneously.ConclusionsThus, overall and severely limited lung function are highly prevalent health conditions. Men and women with a low occupational position and those with low income are the most affected. Socioeconomic indicators cannot be used interchangeably when studying health inequalities in lung functioning. Occupational hazards and physical working conditions are likely to constitute major risks of health inequalities in limited lung functioning and should be investigated as such by future studies.

Childhood obesity's impact on cognition and brain connectivity worsens with low family income.

Childhood obesity and its adverse health consequences have risen worldwide, with low socioeconomic status increasing the risk in high-income countries like the US. Understanding the interplay between childhood obesity, cognition, socioeconomic factors, and the brain is crucial for prevention and treatment. Using data from the ABCD study, we investigated how body mass index (BMI) relates to brain structural and functional connectivity metrics. Obese/overweight children (n = 2,356) were more likely to live in poverty and exhibited lower cognitive performance compared to normal weight children (n = 4,754). Higher BMI was associated with multiple brain measures that were strongest for lower longitudinal diffusivity in corpus callosum, increased activity in cerebellum, insula, and somatomotor cortex, and decreased functional connectivity in multimodal brain areas, with effects more pronounced among children from low-income families. Notably, nearly 80% of the association of low income and 70% of the association of impaired cognition on BMI were mediated by higher brain activity in somatomotor areas. Increased resting activity in somatomotor areas and decreased structural and functional connectivity likely contribute to the higher risk of overweight/obesity among children from low-income families. Supporting low-income families and implementing educational interventions to improve cognition may promote healthy brain function and reduce the risk of obesity.

Strong Electronic Interaction Enables Enhanced Solar-Driven CO2 Reduction into Selective CH4 on SrTiO3 with Photodeposited Pt2+ Sites.

Targeting selective CO2 photoreduction into CH4 remains a challenge due to the sluggish reaction kinetics and poor hydrogenation ability of the unstable intermediate. Here, the active Pt2+ sites were photodeposited on the SrTiO3 photocatalyst, which was well demonstrated to manipulate the CH4 product selectivity. The results showed that SrTiO3 mainly yielded the CO (6.98 μmol g-1) product with poor CH4 (0.17 μmol g-1). With the Pt2+ modification, 100% CH4 selectivity could be obtained with an optimized yield rate of 8.07 μmol g-1. The prominent enhancement resulted from the following roles: (1) the strong electronic interaction between the Pt2+ cocatalyst and SrTiO3 could prompt efficient separation of the photoelectron-hole pairs. (2) The Pt2+ sites were active to capture and activate inert CO2 into HCO3- and CO32- species and allowed fast *COOH formation with the lowered reaction barrier. (3) Compared with SrTiO3, the formed *CO species could be captured tightly on the Pt2+ cocatalyst surface for generating the *CH2 intermediate by the following electron-proton coupling reaction, thus leading to the CH4 product with 100% selectivity.

Addition of Social Determinants of Health to Coronary Heart Disease Risk Prediction: The Multi-Ethnic Study of Atherosclerosis.

Social determinants of health (SDoH) are associated with cardiovascular risk factors and outcomes; however, they are absent from risk prediction models. We aimed to assess if the addition of SDoH improves the predictive ability of the MESA (Multi-Ethnic Study of Atherosclerosis) Risk Score. This was a community-based prospective population cohort study that enrolled 6286 men and women, ages 45-84 years, who were free of clinical coronary heart disease (CHD) at baseline. Data from 10-year follow-up were examined for CHD events, defined as myocardial infarction, fatal CHD, resuscitated cardiac arrest, and revascularization in cases of anginal symptoms. Participants included 53% women with average age of 62 years. When adjusting for traditional cardiovascular risk factors, SDoH, and coronary artery calcium, economic strain, specifically low family income, was associated with a greater risk of CHD events (hazard ratio [HR], 1.42 [95% CI, 1.17-1.71], P value<0.001). Area under the curve of risk prediction with SDoH was 0.822, compared with 0.816 without SDoH. The calibration slope was 0.860 with SDoH and 0.878 in the original model. Significant associations were found between economic/financial SDoH and CHD risk factors and outcomes. Incorporation of SDoH into the MESA Risk Score did not improve predictive ability of the model. Our findings do not support the incorporation of SDoH into current risk prediction algorithms.

The cost of living crisis – how does it impact the health and life of individuals? A survey exploring perceptions in Italy, Germany, Sweden and the United Kingdom

BackgroundThe Cost of Living Crisis (CoLC), a real term reduction in basic income, risks individuals being unable to afford essentials such as heat, food and clothing. The impact of the CoLC is disproportionate – with different population sub-groups more likely to be negatively affected. The objective of this survey was to evaluate the perceived impact of the CoLC on the life and health of participants across four European countries.MethodsA survey housing two questions to investigate the relationship between the CoLC and its perceived impact on life and health was developed. Four European countries (U.K., Sweden, Italy and Germany) took part via the YouGov platform. Logistic regression models were created for each country and question to evaluate which population characteristics were associated with a negative reported impact of the CoLC.ResultsA total of 8,152 unique individuals responded between 17th March and 30th March 2023. Each country was equally represented. Those aged 36–64 were more likely to report a negative impact of the CoLC on their life and health than younger participants (p < 0.001, p = 0.02 respectively). Across all countries, females were significantly more likely to report a negative impact on their life and health, however, when analysed according to country, in Sweden females were less likely to report a negative impact (p < 0.001). Those in lower income families or who reported poor health in the preceding 12 months were significantly more likely to report a negative impact of the CoLC on their life and health. There was no difference within the participant group on the reported impact of the CoLC based on location (rural vs. urban).ConclusionsWe demonstrate the disproportionate negative impact of the CoLC on both life and health in different population subgroups. Germany and Sweden appeared to be more resilient to the effects of the CoLC, particularly for certain population subgroups. It is important to understand the differing effects of a CoLC, and to learn from successful health and economic strategies in order to create targeted policy and create a population resilient to economic shocks.

Low back pain classifications and their associations with disability, quality-of-life, and sociodemographic factors: a comprehensive examination using the PainDETECT questionnaire

Background: Low back pain (LBP) is a debilitating phenomenon that significantly impacts quality-of-life (QOL). The PainDETECT questionnaire (PD-Q) is a screening tool aimed at distinguishing nociceptive pain (NoP) and neuropathic pain (NeP) classifications. Associations between these classifications and patient-reported outcome measures (PROMs) and sociodemographic parameters are yet to be established. Objective: The study aimed to determine the relationship between NeP as assessed by the PD-Q and pain, disability, QOL and sociodemographic factors. Methods: A retrospective analysis of an ongoing prospectively collected database was conducted involving 512 patients aged >18 years who presented to a tertiary spine clinic for LBP having completed the PainDETECT questionnaire, Oswestry Disability Index (ODI), EuroQol Five-Dimensional (EQ-5D) questionnaire or answered questions regarding sociodemographic status. Results: The NeP group had a higher mean numerical rating scale (NRS) score (7.96 ± 1.54 vs. 5.76 ± 2.27, p < 0.001) and lower age (55 ± 15.6 vs. 59 ± 17.8, p < 0.05) compared to the NoP group. When confounded for NRS, analysis of covariance demonstrated an 89.5% higher total ODI score (p < 0.001) and 50.5% lower EQ-5D utility score (p < 0.001) in the NeP compared to NoP group. Smokers and individuals with a no partner marital status were 2.373 (OR = 2.373, 95%C.I. [1.319-4.266], p < 0.01) and 2.384 times (OR = 2.384, 95%C.I. [1.390-4.092], p < 0.01) more likely to have NeP compared to NoP, respectively. Patients with NeP were also of lower income class compared to patients with NoP (Z=-2.45, p < 0.05). Conclusion: NeP was associated with higher levels of disability and lower QOL. Smokers, individuals with a no partner marital status, and individuals with a lower income class were more likely to suffer NeP rather than NoP. These findings have illuminated a crucial notion: in patients with elevated NRS, the detrimental impact of NeP on patient wellbeing underscores the fundamental need to represent pain on a nociceptive-neuropathic continuum, permitting more accurate differentiation of pain components.

Uncovering measurement bias: Differential item functioning by income in the Couples Satisfaction Index.

Relationship satisfaction is among the most popular constructs in family science. As the study of families and romantic couples continues to include more diverse samples, it is imperative to ensure the measures scholars use do not significantly vary in psychometric quality across groups. The goal of this study was to examine the psychometric utility of the four-item Couples Satisfaction Index (CSI-4; Funk & Rogge, 2007) for individuals across the income spectrum. This study uses data from the National Couples' Health and Time Study, which sampled married and cohabiting adults in the United States from late 2020 to early 2021. Differential item functioning in the CSI-4 was assessed based on income (N = 3,497) using item response theory. For individuals experiencing lower incomes, the CSI-4 demonstrated differential functioning compared to their more affluent peers, with a bias against individuals experiencing lower incomes equating to average scores 1.38 units lower than higher income participants on the CSI-4 despite having the same true levels of relationship satisfaction. Differential item functioning was less pronounced when comparing item performance of lower- and middle-income participants, equating to lower income participants scoring .21 units lower than middle-income individuals despite having the same true levels of relationship satisfaction. While advancing diversity in family science, researchers should employ psychometric methods to understand how measures perform across groups, which will help prevent the misinterpretation of statistical bias as real group differences. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cationic Polythiophene as Gene Carrier and Sonosensitizer for Sonodynamic Synergic Gene Therapy of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is one of the most lethal and highly malignant tumors. Sonodynamic therapy (SDT) is a new cancer treatment method. One of its unique advantages lies in the treatment of deep tumors due to its excellent tissue penetration ability caused by ultrasound (US). However, most sonosensitizers suffer from weak sonodynamic activity and poor tumor-targeting ability. In addition, small interfering RNA (siRNA) is a promising anticancer drug, and the efficacy of siRNA-based gene therapy largely depends on the cell impermeability of the gene carrier. Here, we designed and synthesized a cationic polythiophene derivative (PT2) that can be used as a siRNA carrier for gene therapy. Moreover, PT2 could generate singlet oxygen (1O2) and hydroxyl radicals (O2•-) under US irradiation, which suggests that PT2 could be used for SDT. Our study discovered that NUDT1 promoted HCC proliferation and inhibited intracellular ROS production. Therefore, si-NUDT1 was designed and synthesized. NUDT1 silencing can inhibit the proliferation of tumor cells and increase the production of intracellular ROS to further improve the efficacy of SDT. Then, si-NUDT1 assembled with PT2 and DSPE-PEG-FA to prepare a novel tumor-targeting nanodrug (PT2-siRNA@PEG-FA) for synergic SDT and gene therapy of HCC.

Strengthening acute care in low and middle income countries: The role of clinical research

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Residential energy demand, emissions, and expenditures at regional and income-decile level for alternative futures

Abstract Income and its distribution profile are important determinants of residential energy demand and carry direct implications for human well-being and climate. We explore the sensitivity of residential energy systems to income growth and distribution across SSP-RCP scenarios using a global, integrated, multisector dynamics model, GCAM, which tracks national/regional household energy services and fuel choice by income decile. Nation/region energy use patterns across deciles tend to converge over time with aggregate income growth, as higher-income consumers approach satiation levels in floorspace and energy services. However, in some regions, existing within-region inequalities in energy consumption persist over time due to slow income growth in lower income groups. Due to continued differences in fuel types, lower income groups will have higher exposure to household air pollution, despite lower contributions to greenhouse gas emissions. We also find that the share of income dedicated to energy is higher for lower deciles, with strong regional differences.

Prognostic model for resected borderline and locally advanced pancreatic cancer after neoadjuvant chemotherapy.

The current AJCC 8th has been reported to have a poor ability to predict the prognosis in patients with resected borderline resectable pancreatic cancer and locally advanced pancreatic cancer following neoadjuvant chemotherapy. This study was aimed to develop an improved prognostic model by incorporating pathology and parameters of biologic response (BR). A retrospective cohort study was conducted including patients who underwent curative-intent surgery following chemotherapy. We developed a modified ypT staging system and incorporated the BR, involving normalization of carbohydrate antigen 19-9 and reduction in the maximum standardized uptake value simultaneously after chemotherapy. The prognostic performance of the current pathologic system, modified pathologic system, and newly developed system incorporating pathology and BR were compared. In this study, 171 patients underwent surgery following chemotherapy. The modified T stage, which unified ypT2 and ypT3, demonstrated improved prognostic performance than the current staging system (area under the curve: 0.706 vs. 0.661). Biologic unresponsiveness was an independent prognostic factor for worse survival (hazard ratio 2.31, 95% confidence interval 1.50-3.55, P<0.001). The modified pathology with BR system demonstrated the highest discriminative ability in predicting 5-year overall survival than the current pathologic system (area under the curve: 0.785 vs. 0.661, P=0.010) and modified pathologic staging system (area under the curve: 0.785 vs. 0.706, P=0.002). The prognostic model, incorporating modified ypT staging and elevated carbohydrate antigen 19-9 levels and maximum standardized uptake value simultaneously, demonstrated improved results in predicting oncologic outcomes for patients who underwent surgery following neoadjuvant chemotherapy.

Multilingualism and mismatching: Spanish language usage in college admissions essays

In US K-12 education, the Spanish language is subject to practices and policies that limit its expression, especially among racialized Latinx students. However, higher education claims to view Spanish as a positive form of diversity. We therefore examine college admissions essays to analyze how students strategically deploy Spanish in light of these contradictions. We use two years of undergraduate application essays (n = 276,768) and metadata submitted to the University of California by every self-identified Latinx applicant and a racially representative random sample of non-Latinx applicants. To identify Spanish language usage in the text, we develop a computational mixed methods approach by combining machine translation and human reading. Spanish was used by 33% of Latinx and 15% of non-Latinx students with stylistic variation by class and ethnicity. We also find that lower income Mexican and Central American applicants were the most likely to use substantive forms of Spanish in their admissions essays as well as provide translations into English. We posit that this self-translation is an example of students identifying cultural mismatch between themselves and university admissions offices. This linguistic strategy, which we call strategic Spanish, sheds light on how language, culture, and ethnicity intersect in high-stakes evaluation and also helps surface the potential for machine translation as a method for social scientific inquiry.

A surge in queries: Analyzing the increased public interest in dry needling using Google trends – A cross-sectional observational study

BackgroundTo monitor public interest (PI) in information related to Dry needling (DN) therapy and examine potential temporal, seasonal, and income-related trends that may impact PI by using the relative search volume (RSV) from the Google Trends tool for the keyword "Dry Needling." MethodsFor this cross-sectional observational study, a dataset was created using the Google Trends tool from 2004 to the present in the United States (US). To examine potential income-related disparities in PI in DN across the US, RSV values were recorded in the five states with the highest and the lowest median income (Maryland, New Hampshire, New Jersey, Utah, and Washington and Mississippi, West Virginia, Arkansas, New Mexico, Kentucky, respectively). ResultsA linear regression model showed that the PI in DN increased significantly (R2 = 0,902, p < 0.001). There were no significant differences between the RSV values between the month of the year and the season of the year (p = 1.000 and p = 0.997, respectively). RSV values of the five highest-income and low-income states showed significant increases (R2 = 0,624, p < 0.001, and R2 = 0,477, p < 0.001, respectively). More rapid growth in interest in DN in states with high income compared to those with low income (p < 0.001). ConclusionsPI in DN treatment is increasing in both high and low-income states. States with higher incomes are more interested. DN treatment is expected to become more popular, which will lead to a rising demand for comprehensive education in medical schools and clinician training programs. In addition, there will also be a need for easily accessible, high-quality information resources.

Income dynamics and risk of colorectal cancer in individuals with type 2 diabetes: a nationwide population-based cohort study.

Individuals with type 2 diabetes (T2D) have increased colorectal cancer (CRC) risk, but it is unknown whether income dynamics are associated with CRC risk in these individuals. We examined whether persistent low- or high-income and income changes are associated with CRC risk in non-elderly adults with T2D. Using nationally representative data from the Korean Health Insurance Service database, 1,909,492 adults aged 30 to 64 years with T2D and no history of cancer were included between 2009 and 2012 (median follow-up of 7.8 years). We determined income levels based on health insurance premiums and assessed annual income quartiles for the baseline year and the four preceding years. Hazard ratios(HRs) and 95% confidence intervals(CIs) were estimated after adjusting for sociodemographic factors, CRC risk factors, and diabetes duration and treatment. Persistent low income (i.e., lowest income quartile) was associated with increased CRC risk (HRn=5years vs. n=0years 1.11, 95% CI 1.04-1.18; P for trend=0.004). Income declines (i.e., a decrease≥25% in income quantile) were also associated with increased CRC risk (HR≥2 vs. 0 declines 1.10, 95% CI 1.05-1.16; p for trend=0.001). In contrast, persistent high income (i.e., highest income quartile) was associated with decreased CRC risk (HRn=5years vs. n=0years 0.81, 95% CI 0.73-0.89; p for trend<0.0001), which was more pronounced for rectal cancer (HR 0.64, 95% CI 0.53-0.78) and distal colon cancer (HR 0.70, 95% CI 0.57-0.86). Our findings underscore the need for increased public policy awareness of the association between income dynamics and CRC risk in adults with T2D.

Determinants of household food insecurity in Tanzania: A Heckman approach

Household food insecurity is a predominant issue in Tanzania, particularly affecting rural areas where poverty rates are higher. This problem can lead to poor nutritional quality and hinder mental, social, and economic development. The study utilized data from the 2017/18 Tanzania Household Budget Survey to analyse the determinants of food insecurity. Employing the Heckman approach to address the sample selection problem, the study found that household characteristics such as sex of the household head, location, education level, access to credit, household size, marital status, and income significantly reduce the problem of food insecurity among insecure groups. Male-headed, urban location, credit-accessible households and married heads were less food insecure compared to female-headed, rural location and households without access to credit, respectively. In addition, higher household income and education level, as well as smaller household size, positively impacted food expenditure among households. The findings suggest the need for improved credit services, formal education promotion, and targeted food programs, particularly in rural areas, to address household food insecurity effectively in Tanzania.

Individual- and community-level social determinants of health are associated with cognition in older adults with focal epilepsy

ObjectiveEpilepsy is associated with significant health disparities, including access to specialized care and adverse outcomes that have been associated with several social determinants of health (SDOH). We sought to examine the relationship between individual- and community-level SDOH and cognitive outcomes in older adults with epilepsy. Materials and methodsWe collected clinical, SDOH, and neuropsychological data in 57 older adults with epilepsy. Individual-level SDOH included patient factors (quality of education, income, insurance, marital status) and early-life environmental factors (parental education and occupation, childhood employment). Neighborhood deprivation was measured with the Area Deprivation Index (ADI). Stepwise regressions were conducted to examine the independent contribution of individual-level SDOH to cognitive performance, and Spearman rho correlations were conducted to examine the relationship between ADI and cognitive performance. The SDOH profiles of patients who met the criteria for cognitive impairment were examined. ResultsAfter controlling for clinical variables, patient factors (public health insurance, poorer quality of education) and early-life environmental factors (lower mother’s education, lower father’s and mother’s occupational complexity, history of childhood employment) were significant predictors of lower performance on measures of global cognition, verbal learning and memory, processing speed, and executive function. Higher ADI values (greater disadvantage) were associated with lower scores on global cognitive measures, verbal learning and memory, and executive function. Patients who met criteria for cognitive impairment had, on average, a greater number of adverse SDOH, including lower household incomes and father’s education, and higher ADI values compared to those who were cognitively intact. ConclusionWe provide new evidence of the role of individual- and community-level SDOH on cognitive outcomes in older adults with epilepsy. This emerging literature highlights the need to examine SDOH beyond epilepsy-related clinical factors. These data could inform the development of interventions focused on increasing access to epilepsy care, education, and resources and promoting brain and cognitive health within the most at-risk communities.

"There is No Help:" Caregiver Perspectives on Service Needs for Adolescents and Adults with Profound Autism.

The underrepresentation of individuals with profound autism (who require 24/7 access to care) in autism research has resulted in limited knowledge about their service needs and a lack of evidence-based practices tailored to those needs. This study explored caregiver perspectives on service needs, barriers to accessing care, and treatment priorities to guide treatment development and improvement of service delivery. A sequential mixed-methods design integrated quantitative survey data (n = 423; Mage = 18.89years; 26.7% female) with qualitative interviews (n = 20) with caregivers of adolescents and adults with profound autism. Quantitative findings indicated regular socialization opportunities were the most frequently endorsed unmet service need (60.3% of caregivers), followed by primary health care with autism-trained staff (59.3%), social skills instruction (55.8%), life skills instruction (51.3%), and behavioral support (47.3%). Higher likelihood of needing social activity groups was associated with elevated emotional reactivity, higher language level, minoritized ethnicity, and lower household income. Greater need for specialized primary health care was associated with lower income, while the need for social and life skills instruction was associated with increased age and elevated dysphoria. Qualitative analysis identified 10 themes that converged and expanded quantitative findings by highlighting a pervasive shortage of individualized, goal-oriented services, common barriers to care, and the priority of developing centralized treatment settings that coordinate care throughout adulthood. This study identified pressing service needs for adolescents and adults with profound autism in the United States. These insights are crucial for improving the accessibility and quality of clinical care.

Prevalence of traditional eye medicine and self-treatment in Gurage Zone, Rural Ethiopia

IntroductionTraditional medicines are commonly used worldwide, especially in Africa—however, there is limited information on the prevalence and types of traditional eye medicine utilization in Ethiopia. The goal of this study was to determine the prevalence, the type and nature of traditional eye medicine use and practices related to self-medication for ophthalmic diseases in a rural Ethiopian population.MethodsA cross-sectional study was conducted in six randomly selected primary health centers in rural Gurage Zone, Southern Ethiopia. Health-seeking behavior, use of self-medication, and traditional eye medicine were assessed in the population using a semi-structured questionnaire.Descriptive statistics and multivariable logistic regression analysis were computed to determine associated factors for using self-medication and traditional eye medicine.ResultOf the 814 participants interviewed, 487 (59.8%) reported using traditional eye medicine, mainly for combinations of symptoms of ocular redness, irritation, and eye discharge (95.5%). Besides, 604 (74.2%) participants reported self-treatment with tetracycline 1% eye ointment. Older age, females, low income, no formal education, and lack of access to media were risks for utilizing traditional eye medicine.ConclusionThe use of traditional eye medicine and self-treatment are common in this population. Regulatory legislation, public awareness, and making eye care are vital activities required to monitor such practices.

Impact of global smoking prevalence on mortality: a study across income groups

BackgroundSmoking significantly contributes to the mortality rates worldwide, particularly in non-communicable and preventable diseases such as cardiovascular ailments, respiratory conditions, stroke, and lung cancer. This study aims to analyse the impact of smoking on global deaths, and its association with mortality across the main income groups.MethodsThe comprehensive analysis spans 199 countries and territories from 1990 to 2019. The study categorises countries into four income groups: high income, upper middle income, lower middle income, and low income.ResultsThe findings underscore the profound impact of global tobacco smoking on mortality. Notably, cardiovascular disease mortality is notably affected in both upper-middle-income and high-income groups. Chronic respiratory disease mortality rates show a significant impact across all income groups. Moreover, stroke-related mortality is observed in the lower-middle, upper-middle, and high-income groups. These results highlight the pervasive influence of smoking prevalence on global mortality, affecting individuals across various socioeconomic levels.ConclusionThe study underscores the critical implications of smoking on mortality rates, particularly in high-income countries. It emphasises the urgency of targeted interventions in these regions to address the specific challenges posed by tobacco smoking on public health. Policy recommendations include implementing prohibitive measures extending to indoor public areas such as workplaces and public transportation services. Furthermore, allocating funds for research on tobacco and health, is imperative to ensure policymakers are consistently informed about emerging facts and trends in this complex domain.

Screening for frailty and its association with activities of daily living, cognitive impairment, and falls among community-dwelling older adults in China

ObjectivesFrailty is a prevalent geriatric condition that significantly impacts the health of older adults. This study aimed to examine the prevalence of frailty among older Chinese adults aged ≥ 65 years and to assess its association with adverse geriatric outcomes.MethodThis study included 20,724 older adults aged ≥ 65 years in Jiangsu Province, China, utilizing a random, stratified, multistage cluster sampling approach. Frailty was assessed using the 5-item FRAIL scale. Geriatric outcomes, such as independence in activities of daily living (ADL), cognitive impairment, and frequent fall events (occurring four or more times in the preceding year), were evaluated. Logistic regression models were employed to evaluate the association between frailty and geriatric outcomes, with results presented as odds ratios (ORs) and 95% confidence intervals (CIs).ResultsThe mean age of the participants was 73.4 ± 6.4 years. The standardized prevalence of prefrailty and frailty was 35.2% and 10.3%, respectively. Individuals identified as prefrail or frail tended to live in rural areas, have lower educational levels, be widowed, have lower incomes, and engage in less physical activity. Prefrailty and frailty were associated with an increased risk of limitations in BADL (OR: 9.62, 95% CI: 7.43–12.46; and OR: 29.25, 95% CI: 22.42–38.17, respectively) and IADL (OR: 2.54, 95% CI 2.35–2.74; and OR: 5.19, 95% CI 4.66–5.78, respectively), positive cognitive impairment screening (OR: 1.23, 95% CI: 1.16–1.31; and OR: 1.72, 95% CI: 1.56–1.91, respectively), and frequent falls (occurring four or more times in the preceding year) (OR: 3.38, 95% CI: 2.50–4.56; and OR: 8.37, 95% CI: 6.01–11.65). The association between frailty and both limitations in BADL and falls was notably more pronounced among the younger age groups (p for interaction < 0.001).ConclusionsAccording to the 5-item FRAIL scale, frailty was associated with limitations in BADLs and IADLs, positive cognitive impairment screening, and recent falls among older adults living in the community. Screening for frailty in younger age groups has the potential to prevent declines in physical function and falls.