Katsuya Iijima

Aim To investigate the impact of nutrition‐related, physical, and social factors as well as their transitions on frailty over a 7‐year follow‐up period among community‐dwelling older adults. Methods Participants were 868 non‐frail older adults. Frailty was assessed using the Cardiovascular Health Study index. Nutrition‐related, physical, and social factors have been defined in our previous study. Cox regression analysis was conducted to investigate the association between the three factors at baseline and new‐onset frailty during a 7‐year follow‐up period. Furthermore, transitions in the three factors over two/three consecutive years and their association with frailty were investigated using lagged generalized estimating equations. Results The mean age was 73.8 ± 4.8 years (women, 47.0%), and the incidence of frailty was 12.5% during the 7‐year follow‐up period. Compared with participants who met the three factors' criteria at baseline, those who met two, one, and none showed associations with greater adjusted hazard ratios of new‐onset frailty (1.73, 95% confidence interval 0.87–3.42; 2.04 [1.01–4.12]; and 5.69 [2.82–11.47]). Generalized estimating equation analysis showed that, compared with older adults who maintained all the three criteria met, those who improved the quantity of criteria met, who maintained the less than three criteria met, and who decreased the quantity of criteria met showed (marginally) significant associations with greater adjusted odds ratios of frailty (2.86 [0.88–9.31], 3.70 [1.10–12.45], and 4.75 [1.42–15.85]). Conclusions Practicing and maintaining all three factors in daily life are crucial for frailty prevention. Future research should explore strategies to motivate behavioral modifications in these factors at the population level. Geriatr Gerontol Int 2024; 24: 162–169 .