ORIGINAL RESEARCH article
Front. Nutr.
Sec. Nutrition, Psychology and Brain Health
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1590194
Joint Association of Frailty and Depression with New-Onset Digestive Disease among elderly Chinese population
Provisionally accepted
- 1Beijing Hospital, Beijing, Beijing, China
- 2National Center of Gerontology, Institute of Geriatrics, Beijing Hospital, Peking University, Beijing, China
- 3Peking University People's Hospital, Beijing, Beijing Municipality, China
- 4Department of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, Zhejiang Province, China
- 5Department of Geriatrics, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
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Background: Digestive diseases impose a substantial global health burden, yet the joint impact of frailty and depression on their incidence remains underexplored.Methods: This cohort study analyzed 5,506 adults aged ≥65 years from the China Health and Retirement Longitudinal Study (2011-2018). Participants with baseline digestive diseases or missing data were excluded. Cox proportional hazards models assessed associations, while mediation analysis evaluated bidirectional roles of the frailty index (FI) and 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) in new-onset digestive diseases.Results: Over 7 years, 988 participants developed digestive diseases. Frailty (HR=1.66, P<0.001) and depression (HR=1.62, P<0.001) independently increased risk, with the highest hazard in comorbid cases (HR=2.16, P<0.001). Frailty mediated 30.5% of depression's effect, while depression mediated 45.2% of frailty's impact (P<0.05). No multiplicative or additive interaction was observed.Conclusion: Frailty and depression synergistically elevate digestive disease risk in aging populations, with bidirectional mediation underscoring their interdependence. Integrated interventions targeting mental health and geriatric vulnerability may mitigate disease burden.
Keywords: CHARLS, Depression, Digestive disease, Frailty, Mediation analysis
Received: 09 Mar 2025; Accepted: 16 Jul 2025.
Copyright: © 2025 Zhang, Xiong, Meng, Lv and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Du-Juan Yang, Department of Geriatrics, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, China
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