To investigate the frailty state transition in the community-dwelling elderly undergoing health check-up, and related influencing factors.

From September to October 2016, 3 833 residents aged ≥ 60 years undergoing health check-up in Xidu Community Health Center were enrolled in this prospective cohort study by multistage random sampling. All participants completed a questionnaire survey, health examinations, and frailty assessments as measured with the Fried frailty phenotype. A second assessment of frailty status was conducted from June to July 2020, the frailty state transition was analyzed by comparison between two assessments of frailty states. Logistic regression was used to analyze the influencing factors related to frailty progression.

The final cohort consisted of 3 061 participants. At the entering of the study, the median age of participants was 71.0 years, 41.0% were male, 1 563 (51.1%) were prefrail, and 156 (5.1%) were frail. At the follow-up, the frailty status of 1 304 (42.6%) participants was progressed and that of 395 (12.9%) participants was improved from their baseline levels, respectively. Logistic regression showed that age (OR=1.170,95%CI:1.147-1.194), marital status (married: OR=0.377,95%CI:0.292-0.486), physical exercise (never vs. every day: OR=18.610,95%CI:14.461-23.950; sometimes vs. every day: OR=4.210,95%CI:2.186-8.107), baseline frailty state (robust vs. frail: OR=20.464,95%CI:11.779-35.553;prefrail vs. frail: OR=2.147,95%CI:1.270-3.632), stroke (OR=2.195,95%CI:1.454-3.313) and diabetes (OR=1.811,95%CI:1.346-2.437) were identified as independent factors influencing frailty progression (all P<0.05).

Frailty state progression is common among older adults, and its related factors include age, unmarried status, physical exercise, baseline frailty state, stroke and diabetes. It is necessary to identify elderly at high risk for frailty progression and implement medical interventions.

Community health centers; Aged; Frailty; Risk factors