ArticleAging clinical and experimental research2026
Frailty in middle adulthood and associations with negative health-related outcomes in NHANES.
Article in Aging clinical and experimental research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFrailty represents a state of compromised ability to cope with environmental stressors and is associated with negative health-related outcomes in older adults. The study objective is to investigate the prevalence and whether frailty associates with negative health-related outcomes in middle-aged adults.
methodsData were sourced from three 2-year cycles of NHANES surveys and combined with Public-use Linked Mortality Files. A frailty index incorporating thirty variables was developed according to recommended criteria. "Prefrail" individuals were defined with a frailty index value ranging from 0.08 to 0.25, while "Frail" ≥0.25. A 10-year survival analysis was conducted using the Kaplan-Meier estimator, stratified by frailty state, and hazard ratios were calculated. Associations between frailty and outcomes were quantified using logistic regression models. Bootstrapped C-index and Brier score were calculated in the overall sample and stratified by decades of age.
resultsIn a sample of 5,745 middle-aged adults, 11% were identified as frail. Over a median follow-up of 5.9 years, 3% of participants died. The frailty index increased with age and its determinants differed across decades of age. Frail, middle aged, individuals faced a three-to-fourfold higher mortality risk, with a C-index of around 65%. Additionally, frailty was associated with a higher likelihood of hospitalization, increased health-care utilization, and changes in health status. Multimorbidity represented a confounder of frailty in the fourth decade, but not in the fifth.
conclusionFrailty associates with negative health-related outcomes in middle-aged adults, emphasizing the importance of a comprehensive assessment. Multimorbidity only partially accounts for this association.
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