biostudies-literatureUnknown26(1)Yao T<h4>Background</h4>Although the impact of baseline frailty status on chronic disease risks has been well-established, evidence on the associations between changes in frailty status and the incidence of new-onset chronic diseases remains limited.<h4>Methods</h4>A retrospective study of prospectively collected data from the China Health and Retirement Longitudinal Study (CHARLS) including 7 021 adults aged 45 years or older. Frailty status was evaluated by the Rockwood frailty index and classified as robust, pre-frail, or frail. Changes in frailty status were assessed by frailty status at baseline (2011) and the second survey (2013). All chronic diseases were identified by self-reported physician diagnosis. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) BMC public health243https://www.ebi.ac.uk/biostudies/studies/S-EPMC12821276biostudies-literatureAssociations of changes in frailty with multiple chronic diseases in middle aged and elderly adults.PMC12821276Fan HLu WSong BZhang XZhang HYao TGao GLiu CLiu TWang KZhao XGuang XfalseAssociations of changes in frailty with multiple chronic diseases in middle aged and elderly adults.<h4>Background</h4>Although the impact of baseline frailty status on chronic disease risks has been well-established, evidence on the associations between changes in frailty status and the incidence of new-onset chronic diseases remains limited.<h4>Methods</h4>A retrospective study of prospectively collected data from the China Health and Retirement Longitudinal Study (CHARLS) including 7 021 adults aged 45 years or older. Frailty status was evaluated by the Rockwood frailty index and classified as robust, pre-frail, or frail. Changes in frailty status were assessed by frailty status at baseline (2011) and the second survey (2013). All chronic diseases were identified by self-reported physician diagnosis. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) 2025-01-01T00:00:00Z2025 Dec2026-06-06T19:43:24.27Z2026-06-04T03:12:08.312ZS-EPMC128212764139228410.1186/s12889-025-25872-6