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      The Association between Circadian Syndrome and Frailty in US adults: a cross-sectional study of NHANES Data from 2007 to 2018

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          Abstract

          Purpose

          Frailty and Circadian Syndrome (CircS) are prevalent among the elderly, yet the link between them remains underexplored. This study aims to examine the association between CircS and frailty, particularly focusing on the impact of various CircS components on frailty.

          Materials and methods

          We conducted a cross-sectional analysis using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018. The 49-item Frailty Index (FI) was employed to assess frailty. To understand the prevalence of CircS in relation to frailty, we applied three multivariate logistic regression models. Additionally, subgroup and interaction analyses were performed to investigate potential modifying factors.

          Results

          The study included 8,569 participants. In fully adjusted models, individuals with CircS showed a significantly higher risk of frailty compared to those without CircS (Odds Ratio [OR] = 2.18, 95% Confidence Interval [CI]: 1.91–2.49, p < 0.001). A trend of increasing frailty risk with greater CircS component was observed (trend test p < 0.001). Age ( p = 0.01) and race ( p = 0.02) interactions notably influenced this association, although the direction of effect was consistent across subgroups. Sensitivity analysis further confirmed the strength of this relationship.

          Conclusion

          This study identifies a strong positive correlation between CircS and frailty in the elderly. The risk of frailty escalates with an increasing number of CircS components. These findings highlight the intricate interplay between circadian syndrome and frailty in older adults, offering valuable insights for developing targeted prevention and intervention strategies.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s40520-024-02745-3.

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          Most cited references43

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          Frailty in elderly people

          Andrew B. Clegg, John Young, Steve Iliffe … (2013)
          Frailty is the most problematic expression of population ageing. It is a state of vulnerability to poor resolution of homoeostasis after a stressor event and is a consequence of cumulative decline in many physiological systems during a lifetime. This cumulative decline depletes homoeostatic reserves until minor stressor events trigger disproportionate changes in health status. In landmark studies, investigators have developed valid models of frailty and these models have allowed epidemiological investigations that show the association between frailty and adverse health outcomes. We need to develop more efficient methods to detect frailty and measure its severity in routine clinical practice, especially methods that are useful for primary care. Such progress would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care. Copyright © 2013 Elsevier Ltd. All rights reserved.
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            Frailty: implications for clinical practice and public health

            Emiel Hoogendijk, Jonathan Afilalo, Kristine Ensrud … (2019)
            Frailty is an emerging global health burden, with major implications for clinical practice and public health. The prevalence of frailty is expected to rise alongside rapid growth in the ageing population. The course of frailty is characterised by a decline in functioning across multiple physiological systems, accompanied by an increased vulnerability to stressors. Having frailty places a person at increased risk of adverse outcomes, including falls, hospitalisation, and mortality. Studies have shown a clear pattern of increased health-care costs and use associated with frailty. All older adults are at risk of developing frailty, although risk levels are substantially higher among those with comorbidities, low socioeconomic position, poor diet, and sedentary lifestyles. Lifestyle and clinical risk factors are potentially modifiable by specific interventions and preventive actions. The concept of frailty is increasingly being used in primary, acute, and specialist care. However, despite efforts over the past three decades, agreement on a standard instrument to identify frailty has not yet been achieved. In this Series paper, we provide an overview of the global impact and burden of frailty, the usefulness of the frailty concept in clinical practice, potential targets for frailty prevention, and directions that need to be explored in the future.
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              Frailty in Relation to the Accumulation of Deficits

              K. Rockwood, A B Mitnitski (2007)
              This review article summarizes how frailty can be considered in relation to deficit accumulation. Recalling that frailty is an age-associated, nonspecific vulnerability, we consider symptoms, signs, diseases, and disabilities as deficits, which are combined in a frailty index. An individual's frailty index score reflects the proportion of potential deficits present in that person, and indicates the likelihood that frailty is present. Although based on a simple count, the frailty index shows several interesting properties, including a characteristic rate of accumulation, a submaximal limit, and characteristic changes with age in its distribution. The frailty index, as a state variable, is able to quantitatively summarize vulnerability. Future studies include the application of network analyses and stochastic analytical techniques to the evaluation of the frailty index and the description of other state variables in relation to frailty.
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                Author and article information

                Contributors
                Xiaoping Chen: Xiaopingchen13@126.com
                Journal
                Journal ID (nlm-ta): Aging Clin Exp Res
                Journal ID (iso-abbrev): Aging Clin Exp Res
                Title: Aging Clinical and Experimental Research
                Publisher: Springer International Publishing (Cham )
                ISSN (Print): 1594-0667
                ISSN (Electronic): 1720-8319
                Publication date (Electronic): 7 May 2024
                Publication date PMC-release: 7 May 2024
                Publication date (Print): 2024
                Volume: 36
                Issue: 1
                Electronic Location Identifier: 105
                Affiliations
                [1 ]Cardiology Department, West China Hospital, Sichuan University, ( https://ror.org/011ashp19) Chengdu, 610041 Sichuan Province People’s Republic of China
                [2 ]Department of Internal Medicine, The Affiliated Hospital of Xizang Minzu University, ( https://ror.org/042170a43) Xianyang City, Shaanxi Province 712000 People’s Republic of China
                Article
                Publisher ID: 2745
                DOI: 10.1007/s40520-024-02745-3
                PMC ID: 11076391
                PubMed ID: 38713270
                SO-VID: b0ebc6b9-b0e1-475d-84b4-861354a3e530
                Copyright © © The Author(s) 2024
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 30 January 2024
                Date accepted : 21 March 2024
                Categories
                Subject: Original Article
                Custom metadata
                issue-copyright-statement © Springer Nature Switzerland AG 2024

                Keywords: circadian syndrome,metabolic syndrome,cross-sectional study,frailty,nahnes
                Data availability:
                Keywords: circadian syndrome, metabolic syndrome, cross-sectional study, frailty, nahnes

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