ABSTRACT
Background:
Frailty is a
public health problem for ageing society, however, evidence is lacking regarding its impact on intestinal functions. We aimed to examine prospective relationships of
frailty and pre-
frailty in middle-
aged and older
adults with incident
irritable bowel syndrome (IBS) in a large-scale
population-based cohort.
Methods:
Participants (
aged 37-73 years) free of IBS, coeliac
disease,
inflammatory bowel disease and any
cancer at baseline were included, using data from the
UK Biobank (collected 2006-2010, 22 assessment centres). Participants without available
primary care data were excluded.
Frailty status was assessed using Fried
phenotype including five criteria (
weight loss, exhaustion, low
grip strength, low
physical activity, slow
walking pace). Participants
who met at least three criteria were defined as frail, and those
who fulfilled one or two criteria were defined as pre-frail. Primary outcome was incident IBS. Cox
proportional hazard model was conducted to examine the associated
risk of incident IBS.
Findings:
Among 176,423 participants (mean age 56.19 years), 7994 (4.5%) and 78,957 (44.8%) were frail and pre-frail at baseline. During a median of 13.2-year follow-up, 4155 cases of incident IBS were identified. Compared with non-frail individuals, those with frail (HR = 1.80, 95% CI 1.59-2.04) and pre-frail (HR = 1.21, 1.14-1.30) showed significantly higher
risk of developing IBS after multivariable
adjustment (Ptrend < 0.001). Specifically, the positive
association was not only observed in older
adults (HR = 1.69, 1.37-2.08 for frail; 1.24, 1.12-1.39 for pre-frail), but also in
middle-aged adults (HR = 1.90, 1.62-2.22 for frail; 1.19, 1.10-1.30 for pre-frail), both with Ptrend < 0.001. Further
sensitivity analysis and subgroup
analysis indicated
similar results.
Interpretation:
Frailty and pre-
frailty in middle-
aged and older
adults are associated with increased
risk of incident
clinical diagnosis of IBS.
Funding:
National
Natural Science Foundation of
China (No. 82070550) & National Key
Research and Development Program of
China (2022YFC2504002, 2022YFC2504003).
