Bidirectional transitions of frailty states among middle-aged and older adults: a longitudinal cohort analysis using a multi-state Markov model based on the China Health and Retirement Longitudinal Study.

ABSTRACT:

Background and objectives

Frailty is a dynamic syndrome increasing older adults' vulnerability to adverse outcomes. Longitudinal data on frailty transitions and their influencing factors remain limited. We aimed to examine bidirectional frailty transitions among middle-aged and older adults using a multi-state Markov (MSM) model.

Research design and methods

Data were obtained from four waves (2011-2018) of the China Health and Retirement Longitudinal Study (CHARLS), including 15 763 participants aged ≥45 years. Frailty was assessed using a 32-item frailty index. MSM models estimated transition probabilities, mean sojourn times, and covariate effects. Additional analyses examined age- and gender-specific patterns and included an age × gender interaction term.

Results

B

SUBMITTER: Tong Y 

PROVIDER: S-EPMC12685369 | biostudies-literature | 2025

REPOSITORIES: biostudies-literature