ArticleFrontiers in public health2026
Labor intensity as an independent risk factor for frailty in older farmers: evidence from a multi-region survey in Guizhou, China.
Article in Frontiers in 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.
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Abstract
Background: The global agricultural labor force has declined from 41% in 1995 to 26% in 2023, while farming populations in Asian newly industrialized countries are aging rapidly. China, as a representative case, faces challenges in agricultural labor force renewal, with older farmers serving as "last guardians" through high-intensity labor. The prevalence of frailty among rural Chinese adults aged 60 years and older is 23.31%, significantly higher than in urban areas. However, previous studies have treated physical activity as homogeneous, failing to distinguish occupational agricultural labor from leisure-time activity. This study examined the association between agricultural labor intensity and frailty among older farmers, identifies risk thresholds, and provides evidence for promoting healthy aging during agricultural transformation. Methods: We conducted a multiregion cross-sectional survey in Guizhou Province, China. A total of 1,443 older farmers aged 60-79 years were selected using multifactor stratified sampling. Frailty was assessed using the Fried Frailty Phenotype. Labor intensity was quantified as total daily energy expenditure (kcal/day), calculated as body weight (kg) × daily working hours (h) × metabolic equivalent of task (MET). Multivariable logistic regression analyses were performed with stepwise adjustment for demographic, lifestyle, and health-related confounders. Results: The prevalence of frailty among older farmers was 19.7%, with significant regional variation. Advanced age, low educational attainment, malnutrition, polypharmacy, widowhood, and multiple pain sites were independently associated with frailty. A non-linear association was observed between agricultural labor intensity and frailty. Daily labor energy expenditure exceeding 1,752 kcal/day was associated with significantly increased frailty risk (OR = 3.596; 95% CI: 2.386-5.420; Conclusions: High labor intensity represents a strong, independent risk factor for frailty among older farmers. These findings underscore the urgent need for targeted interventions and occupational health guidelines to protect this vulnerable population from excessive physical workloads and promote healthy aging in rural communities.
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