ArticleAging clinical and experimental research2026
Trajectory of frailty among the older people in a community setting: A cohort study from the Shizuoka Kokuho Database.
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
backgroundLong-term population-level evidence on frailty trajectories, particularly among the oldest-old, remains limited.
aimsTo evaluate 6-year frailty trajectories in community-dwelling adults aged ≥ 50 years.
methodsWe conducted a cohort study using a regional Japanese administrative claims database from 2012 to 2020. Frailty was measured using the electronic Frailty Index. Inverse probability of censoring weighting accounted for insurance-plan disenrollment, and weighted multinomial logistic regression estimated adjusted 6-year transition probabilities.
resultsThe cohort included 1,040,663 adults aged ≥ 50 years (mean age, 73.2 years; 58.6% women). Six-year final status worsened with baseline frailty severity: death increased from 12.7% among fit individuals to 23.8%, 34.7%, and 49.1% among those with mild, moderate, and severe frailty. Among those with severe frailty, recovery to fit status occurred in 2.6%, and recovery to fit or mild frailty in 9.0%; 91.0% died or were in moderate-to-severe frailty. Age- and sex-specific patterns differed. Among fit adults aged 65-74 years, women had lower mortality than men (4.3% vs. 8.7%) and higher probabilities of being alive with mild or moderate frailty (26.6% vs. 21.8%; 6.1% vs. 4.9%). Among fit adults aged ≥ 85 years, death was the dominant final state, although women had lower mortality (53.9% vs. 59.0%) and higher fit status (21.7% vs. 18.8%). DISCUSSION: Severe frailty was rarely followed by recovery to fit or mild status. Sex differences in frailty trajectories varied across age groups.
conclusionsThese findings highlight severe frailty as a late high-risk state and may inform age- and sex-specific frailty risk stratification and care planning.
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