Association between circadian syndrome and frailty progression among middle-aged and older adults in China: A longitudinal study based on CHARLS.
TL;DR
This study showed that baseline CircS status was significantly associated with unfavorable frailty trajectories, while a greater CircS component burden was associated with both higher baseline FI levels and a faster subsequent increase in FI.
Abstract
Background
Frailty is a significant predictor of adverse outcomes. Circadian syndrome (CircS), a cluster of cardiometabolic risk factors linked to circadian disruption, may interact with frailty; however, evidence for this relationship remains limited.
Methods
A total of 7330 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included. CircS was defined by seven components. Frailty was measured by the frailty index (FI). Group-based trajectory modeling (GBTM) was employed to identify different frailty trajectories. Multinomial logistic regression models were conducted to assess the association between baseline CircS status and frailty trajectories. Linear mixed-effects models were used to examine the association between the number of baseline CircS components and the subsequent rate of change in FI over time.
Results
Three frailty trajectories were identified: low-stable frailty (n = 4670, 63.71%), moderate-rising frailty (n = 2109, 28.77%), and high-stable frailty (n = 551, 7.52%). Compared to participants without CircS, those with CircS at baseline had a significantly higher risk of belonging to the moderate-rising trajectory (RRR = 2.48, 95% CI: 2.17, 2.84, p < 0.001) and the high-stable trajectory (RRR = 4.37, 95% CI: 3.51, 5.45, p < 0.001). Furthermore, participants with 4, 5, and ≥ 6 CircS components had greater annual increases in FI, with additional increases of 0.0022 (95% CI: 0.0011, 0.0033, p < 0.001), 0.0020 (95% CI: 0.0007, 0.0033, p < 0.01), and 0.0033 (95% CI: 0.0016, 0.0049, p < 0.001) per year, respectively, compared with those with <4 components.
Conclusions
This study showed that baseline CircS status was significantly associated with unfavorable frailty trajectories, while a greater CircS component burden was associated with both higher baseline FI levels and a faster subsequent increase in FI. These findings highlight the potential relevance of CircS for identifying individuals at increased risk of adverse frailty outcomes.