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Background: The association between fine particular matter (PM2.5) and frailty is less studied, and the national burden of PM2.5-related frailty in China is unknown., Objective: To explore the association between PM2.5 exposure and incident frailty in older adults, and estimate the corresponding disease burden., Design: Chinese Longitudinal Healthy Longevity Survey from 1998 to 2014., Setting: Twenty-three provinces in China., Subjects: A total of 25,047 participants aged ≥65-year-old., Methods: Cox proportional hazards models were performed to evaluate the association between PM2.5 and frailty in older adults. A method adapted from the Global Burden of Disease Study was used to calculate the PM2.5-related frailty disease burden., Results: A total of 5,733 incidents of frailty were observed during 107,814.8 person-years follow-up. A 10 μg/m3 increment of PM2.5 was associated with a 5.0% increase in the risk of frailty (Hazard Ratio = 1.05, 95% confidence interval = [1.03-1.07]). Monotonic, but non-linear exposure-response, relationships of PM2.5 with risk of frailty were observed, and slopes were steeper at concentrations >50 μg/m³. Considering the interaction between population ageing and mitigation of PM2.5, the PM2.5-related frailty cases were almost unchanged in 2010, 2020 and 2030, with estimations of 664,097, 730,858 and 665,169, respectively., Conclusions: This nation-wide prospective cohort study showed a positive association between long-term PM2.5 exposure and frailty incidence. The estimated disease burden indicated that implementing clean air actions may prevent frailty and substantially offset the burden of population ageing worldwide., (© The Author(s) 2023. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Introduction: About half of adults aged ≥80 years suffer from frailty. Exercise is considered effective in preventing frailty but may be inapplicable to adults aged ≥80 years due to physical limitations. As an alternative, we aimed to explore the association of leisure activities with frailty and identify potential interaction with established polygenic risk score (PRS) among adults aged ≥80 years., Methods: Analyses were performed in a prospective cohort study of 7,471 community-living older adults aged ≥80 years who were recruited between 2002 and 2014 from 23 provinces in China. Leisure activity was assessed using a seven-question leisure activity index and frailty was defined as a frailty index ≥0.25 using a validated 39-item health-related scale. The PRS was constructed using 59 single-nucleotide polymorphisms associated with frailty in a subsample of 2,541 older adults. Cox proportional hazards models were used to explore the associations of leisure activities, PRS with frailty., Results: The mean age of participants was 89.4 ± 6.6 years (range: 80-116). In total, 2,930 cases of frailty were identified during 42,216 person-years of follow-up. Each 1 unit increase in the leisure activity index was associated with 12% lower risk of frailty (hazard ratio: 0.88 [95% confidence interval, 0.85-0.91]). Participants with high genetic risk (PRS >2.47 × 10-4) suffered from 26% higher risk of frailty. Interaction between leisure activity and genetic risk was not observed., Conclusion: Evidence is presented for the independent association of leisure activities and genetic risk with frailty. Engagement in leisure activities is suggested to be associated with lower risk of frailty across all levels of genetic risk among adults aged ≥80 years., (© 2023 S. Karger AG, Basel.)

Lead (Pb) is a widespread environmental contaminant, associated with a higher risk of functional impairment that can lead to frailty in older adults. However, few studies focused on the association of Pb exposure with frailty among the oldest old (aged ≥ 80 years). In this study, we aimed to assess the associations of Pb with frailty and its components in the oldest old. The included individuals were the oldest old aged ≥ 80 years who participated in a 2017 cross-sectional survey of the Healthy Aging and Biomarkers Cohort Study. Frailty was ascertained by the frailty index, which was created based on health deficits. We used logistic regression models to estimate the association of blood Pb with frailty and its components. The geometric mean and median of blood Pb were 38.51 μg/L and 36.27 μg/L among the oldest old, respectively. Compared with the first quartile of blood Pb, participants in the fourth quartile had higher risk of frailty and its components, the ORs are 1.71 (1.22-2.41), 1.99 (1.35-2.94), 1.91 (1.25-2.93), 1.57 (1.13-2.17) and 1.43 (1.05-1.96), for frailty, ADL disability, IADL disability, functional limitations, and hearing loss in the oldest old, respectively. There was a significant interaction between blood Pb and frailty in different age groups. In conclusion, our findings provide preliminary evidence that higher blood Pb may increase the risk of frailty among the oldest old by increasing the risk of disability in four physical functions: disability in ADL, disability in IADL, functional limitations, and hearing loss., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)