ArticleOsteoarthritis and cartilage open2026
Frailty is associated with lower-limb osteoarthritis incidence over six-years regardless of sex and type of frailty index in the Canadian longitudinal study on aging.
Article in Osteoarthritis and cartilage open, 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
Objective: We aimed to test whether increases in frailty are associated with a higher likelihood of developing lower-limb osteoarthritis over six-years, with stronger associations in females, and to compare whether results are specific to a self-reported versus a comprehensive frailty index. Design: Data were drawn from the Canadian Longitudinal Study on Aging's comprehensive cohort. Frailty was quantified using a self-reported (FI-SELF; 46-items; n = 24,212) and comprehensive frailty index (FI-COM; 86-items; n = 13,757) at baseline, three-year, and six-year follow-up. Incident osteoarthritis was defined as self-reporting whether a doctor had ever diagnosed hip or knee osteoarthritis. Time-varying Cox proportional hazards models examined the relation between frailty and osteoarthritis incidence. Models included a frailty × sex interaction and adjusted for age, body mass index, and marital status. Sex-stratified models were also conducted. Results: Higher frailty was associated with a greater likelihood of developing lower-limb osteoarthritis over six-years. Using the FI-SELF, each 0.01-point increase (one additional health deficit) corresponded to a 4.7% higher hazard of osteoarthritis in males (HR = 1.047, 95% CI 1.042-1.051) and a 5.0% higher hazard in females (HR = 1.050, 95% CI 1.047-1.054). However, there was no significant frailty × sex interaction for either the FI-SELF (p = 0.057) or FI-COM (p = 0.406), indicating similar associations across sexes. Findings were consistent between the FI-SELF and FI-COM. Females exhibited higher frailty scores than males at baseline, three-year, and six-year follow-up (all p < 0.001). Conclusion: Longitudinal changes in frailty are independently associated with incident lower-limb osteoarthritis in both males and females over six-years, with similar results when using either the FI-SELF or FI-COM.
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