ArticleThe Journal of frailty & aging2025
The bidirectional relationship between knee osteoarthritis and frailty in China: A longitudinal study.
Article in The Journal of frailty & aging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Association of latent class trajectories of frailty with incident symptomatic knee osteoarthritis in Chinese postmenopausal women: a nationwide cohort study from China.Scientific reports · 2026Article
- A Study on the Bidirectional Effects of Depression and Household Savings: Empirical Evidence from CHARLS.Healthcare (Basel, Switzerland) · 2026Article
- Frailty Transition and Risk of New-Onset Arthritis Among Adults Aged 45 Years and Older: A Longitudinal Analysis of CHARLS.Healthcare (Basel, Switzerland) · 2026Article
- Article
- Changes in frailty and incident risk of degenerative bone and joint diseases and their multimorbidity: a prospective cohort study.Frontiers in public health · 2026Article
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Authors and funding
4 authors.
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Abstract
backgroundKnee osteoarthritis is a common disease that causes disability and loss of independence in middle-aged and older adults, and may interact with frailty through shared pathways. Understanding their bidirectional relationship is clinically meaningful for early intervention. This study aimed to investigate the associations between knee osteoarthritis and frailty among middle-aged and older adults in China.
methodsThe data for this study came from three waves (baseline 2011, follow-up 2013 and 2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 3560 participants were included. Frailty was assessed with the Frailty Index. Knee osteoarthritis was defined as physician-diagnosed arthritis with self-reported knee pain. Longitudinal bidirectional relationships were found using cross-lagged panel models and random-intercept cross-lagged panel models.
resultsA longitudinal bidirectional relationship between knee osteoarthritis and frailty was observed, with a stronger effect of frailty on subsequent knee osteoarthritis (Wald χ² = 11.416, P < 0.001). At the between-person level, individuals with knee osteoarthritis also tend to have a higher risk of frailty (β= 0.454, P < 0.001). At the within-person level, the predictive effect of knee osteoarthritis on frailty was significant only in the long term (β=0.055, P < 0.05). Subgroup analyses showed that this longitudinal bidirectional relationship was particularly strong among females as well as those with low education levels.
conclusionsThis study reveals a longitudinal bidirectional relationship between knee osteoarthritis and frailty in middle-aged and older adults. In particular, the dominant role of frailty in the development of knee osteoarthritis was found, as well as the negative impact of knee osteoarthritis accumulation on frailty over time. This result suggests that targeting frailty early interventions in an ageing society may help to interrupt the vicious cycle of knee osteoarthritis and reduce the risk of disability. It provides a scientific basis for public health strategies.
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