Evidence map›Paper›PMID 42026562›Full record

ArticleBMC public health2026

Association between body mass index and frailty for middle-aged and older adults in Japan: a cross-sectional study of the Osaka health disparity solution program.

Tsukasa Yoshida, Erika Hikita, Daiki Watanabe, Takashi Nakagata, Yosuke Yamada, Naomi Sawada, Megumi Okabayashi, Hidekazu Shimada, Nobuo Nishi, Motohiko Miyachi

Abstract read
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In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Tsukasa Yoshida *Graduate School of Medicine, Tohoku University, Seiryomachi 2-1, Aoba-ku, Sendai-city, Miyagi, 980-8575, Japan. tsukasa.yoshida.a3@tohoku.ac.jp.
Erika Hikita *National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Senriokashinmachi 3-17, Settsu-city, Osaka, 566-002, Japan.
Daiki WatanabeNational Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Senriokashinmachi 3-17, Settsu-city, Osaka, 566-002, Japan.
Takashi NakagataNational Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Senriokashinmachi 3-17, Settsu-city, Osaka, 566-002, Japan.
Yosuke YamadaGraduate School of Medicine, Tohoku University, Seiryomachi 2-1, Aoba-ku, Sendai-city, Miyagi, 980-8575, Japan.
Naomi SawadaNational Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Senriokashinmachi 3-17, Settsu-city, Osaka, 566-002, Japan.
Megumi OkabayashiDepartment of Health and Medical, Osaka Prefectural Government, Otemae 2-1-22, Osaka-city, Osaka, 540-8570, Japan.
Hidekazu ShimadaDepartment of Health and Medical, Osaka Prefectural Government, Otemae 2-1-22, Osaka-city, Osaka, 540-8570, Japan.
Nobuo NishiNational Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Senriokashinmachi 3-17, Settsu-city, Osaka, 566-002, Japan.
Motohiko MiyachiNational Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Senriokashinmachi 3-17, Settsu-city, Osaka, 566-002, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLow and high body mass index (BMI) are reported to be associated with frailty in older adults. Since the optimal BMI associated with a low risk of mortality varies with age, the association between BMI and frailty might also differ by age. This study examined the association between BMI and frailty in middle-aged and older adults in Japan.

methodsWe conducted face-to-face and mail surveys in Settsu city and mail survey in Hannan city in Osaka, Japan. The association between BMI and frailty was analyzed among 8,815 participants using mail surveys. Frailty was evaluated using two tools, the Kihon Checklist (KCL) and the Frailty Screening Index (FSI). BMI (kg/m2) was categorized into the < 18.5, ≥ 18.5–<20.0, ≥ 20–<22.5, ≥ 22.5–<25.0, ≥ 25.0–<27.5, and ≥ 27.5 kg/m2 groups. We analyzed the association between BMI and frailty using multivariable logistic regression, with BMI ≥ 22.5–<25.0 kg/m2 as the reference to calculate the odds ratios (OR) and 95% confidence intervals (95%CI). Restricted cubic spline analyses were also performed, with knots placed at the 5th, 50th (as reference), and 95th percentiles of BMI. We performed all analyses separately for the < 65 and ≥ 65 years age groups.

resultsBMI < 18.5 (OR = 1.882, 95%CI: 1.263–2.805) was significantly associated with KCL-measured frailty in individuals aged < 65 years, and BMI < 18.5 (OR = 1.807, 95%CI: 1.291–2.531) and ≥ 27.5 (OR = 1.562, 95%CI: 1.156–2.111) were significantly associated with KCL-measured frailty in those aged ≥ 65 years. BMI ≥ 25.0–<27.5 (OR = 1.426, 95%CI: 1.055–1.927) and ≥ 27.5 (OR = 1.473, 95%CI: 1.093–1.985) were significantly associated with FSI-measured frailty in individuals aged < 65 years, and BMI ≥ 27.5 (OR = 1.988, 95%CI: 1.432–2.759) was significantly associated with frailty in those aged ≥ 65 years. The spline models showed U-shaped associations for KCL-measured frailty for both age groups, a positive linear association for FSI-measured frailty among those aged < 65 years, and an L-shaped association for FSI-measured frailty among those aged ≥ 65 years.

conclusionThe association between BMI and frailty differed by age. The collation of all the results of this study suggests that both low and high BMI are associated with frailty in middle-aged and older adults. Based on the results, it is speculated lifestyle habits that promote proximity to “normal weight” may help prevent frailty.

trial registrationUMIN000008105 (Registration date: May 29th 2019; Website: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000042027 ).

Indexed as

Body Mass IndexFrail ElderlyFrailtyAgedAged, 80 and overCross-Sectional StudiesFemaleHumansJapanMaleMiddle AgedAsiaFrailty screening index (FSI) or simplified frailty index (SFI)Kihon Checklist (KCL)Logistic regressionRestricted cubic spline analysis

Identifiers

PMID42026562
PMCPMC13173948

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.