Long-term fine particular exposure and incidence of frailty in older adults: findings from the Chinese Longitudinal Healthy Longevity Survey. (14th February 2023)

• Record Type: Journal Article
• Authors: Lv, Yuebin; Yang, Ze; Ye, Lihong; Jiang, Meijie; Zhou, Jinhui; Guo, Yanbo; Qiu, Yidan; Li, Xinwei; Chen, Chen; Ju, Aipeng; Wang, Jun; Li, Chenfeng; Li, Yang; Wang, Jiaonan; Zhang, Juan; Ji, John S; Li, Tiantian; Baccarelli, Andrea A; Gao, Xu; Shi, Xiaoming
• Is Part Of: Age and ageing. Volume 52:Number 2(2023)
• Publication Date: 2023-02-14
• Subjects: fine particular matter (PM2.5) -- frailty -- older adults -- Chinese Longitudinal Healthy Longevity Survey (CLHLS) -- disease burden -- older people; Aging -- Periodicals; Geriatrics -- Periodicals; 618.97
• DOI: 10.1093/ageing/afad009
• Languages: English
• ISSNs: 0002-0729

Abstract

Abstract: 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/m 3 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.