ArticleBMC geriatrics2024
Association between healthy lifestyle and frailty in adults and mediating role of weight-adjusted waist index: results from NHANES.
Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- The joint association of health-enhancing walking and healthful diet with central obesity: a longitudinal repeated-measures study.International journal of obesity (2005) · 2026Article
- Interpretable machine learning framework for frailty risk prediction using NHANES 2007-2018: A cross-sectional study.Medicine · 2026Article
- Trends and lifestyle contributions to frailty in US adults aged 50 and older: analysis of health and retirement study data (2004-2020).BMC public health · 2026Article
- Change of frailty index and anthropometric indices in patients with chronic obstructive pulmonary disease.BMC pulmonary medicine · 2026Article
- Unveiling the link between oral microbial α-diversity, advanced cardiovascular-kidney-metabolic syndrome, and mortality.Journal of oral microbiology · 2026Article
- Association and discriminative performance of relative fat mass for frailty index in US older adultsoxy_comment_end.Scientific reports · 2025Article
- Relationship between sedentary time and cognitive decline in hypertensive patients-mediating role of the weight-adjusted waist circumference index.Scientific reports · 2025Article
- Diet-microbiome synergy: unraveling the combined impact on frailty through interactions and mediation.Nutrition journal · 2025Article
- Association of lifestyle modifications with frailty in older adults: A cross-sectional study using NHANES.The Journal of frailty & aging · 2025Article
- Association between alpha-1-acid glycoprotein and frailty in US females aged 20-49 years: analysis of NHANES data (2015-2023).Scientific reports · 2025Article
- Development and validation of nomograms to predict frailty-worsening trajectories among Chinese older adults.Frontiers in public health · 2025Article
- Weight-Adjusted Waist Index (WWI)-A Promising Anthropometric Indicator of Depressive Symptoms in Hospitalized Older Patients.Nutrients · 2024Article
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8 authors.
Funding
Abstract
backgroundThe relationship between healthy lifestyle and frailty remains unclear. Healthy weight is crucial for overall well-being, but using body mass index (BMI) to evaluate weight management is inefficient. This study clarifies the association between healthy lifestyle or its factors (non-smoking, moderate drinking, healthy weight, healthy diet, sufficeint physical activity, and non-sedentary) and frailty, and the feasibility of using the weight-adjusted waist index (WWI) reflecting central obesity as an intermediate indicator.
methodsThis study included 4,473 participants from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Healthy lifestyle quality was assessed by summing the scores of each healthy lifestyle factor. Frailty was assessed using a 49-item frailty index (FI), categorizing participants into robust, pre-frail, and frail. Logistic regression to investigate the association between healthy lifestyle or its factors, WWI, and frailty. Smooth curve fitting and threshold effect analyses were used to elucidate the nonlinear association. Subgroup and two other sensitivity analyses were conducted to confirm the stability of the results. A causal mediation model examined the proportion of frailty mediated by WWI.
resultsThe study identified 13.98% of the participants as frail. Optimal healthy lifestyle and frailty were negatively associated (OR: 0.39, 95%CI: 0.27-0.58). Five healthy lifestyle factors (non-smoking, healthy weight, healthy diet, sufficient physical activity, and non-sedentary) were associated with a lower prevalence of frailty, with odds ratios (OR) ranging from 0.48 to 0.61. We also analyzed the association between a healthy lifestyle and WWI (OR: 0.32, 95%CI: 0.27-0.37), WWI and frailty (OR: 1.85, 95%CI: 1.59-2.16). A positive association between WWI and FI was observed beyond the inflection point (9.99) (OR: 0.03, 95%CI: 0.02-0.03). Subgroup and sensitivity analyses confirmed stable associations between healthy lifestyle, WWI, and frailty. WWI partially mediated the association between a healthy lifestyle and frailty (mediating ratio = 20.50-20.65%).
conclusionsAn optimal healthy lifestyle and positive healthy lifestyle factors are associated with a lower incidence of frailty. WWI may mediate the relationship between a healthy lifestyle and frailty.
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