Study on the association between living arrangements and frailty among the oldest-old in China

ZHANG Qian; ZHONG Wenfang; XIE Jiahao; YAN Hao; GAO Jian; CHEN Peiliang; MAO Chen

doi:10.16462/j.cnki.zhjbkz.2025.07.002

Volume 29 Issue 7

Jul. 2025

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ZHANG Qian, ZHONG Wenfang, XIE Jiahao, YAN Hao, GAO Jian, CHEN Peiliang, MAO Chen. Study on the association between living arrangements and frailty among the oldest-old in China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(7): 750-757. doi: 10.16462/j.cnki.zhjbkz.2025.07.002

Citation:

ZHANG Qian, ZHONG Wenfang, XIE Jiahao, YAN Hao, GAO Jian, CHEN Peiliang, MAO Chen. Study on the association between living arrangements and frailty among the oldest-old in China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(7): 750-757. doi: 10.16462/j.cnki.zhjbkz.2025.07.002

Citation:

ZHANG Qian, ZHONG Wenfang, XIE Jiahao, YAN Hao, GAO Jian, CHEN Peiliang, MAO Chen. Study on the association between living arrangements and frailty among the oldest-old in China[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(7): 750-757. doi: 10.16462/j.cnki.zhjbkz.2025.07.002

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Study on the association between living arrangements and frailty among the oldest-old in China

doi: 10.16462/j.cnki.zhjbkz.2025.07.002

School of Public Health, Southern Medical University, Guangzhou 510515, China

Funds:

National Natural Science Foundation of China 82425052

National Key Research and Development Program of China 2018YFC2000400

More Information

Corresponding author: MAO Chen, E-mail: maochen9@smu.edu.cn
Received Date: 2025-01-08
Rev Recd Date: 2025-04-27

Available Online: 2025-08-11

Publish Date: 2025-07-10

Abstract

Abstract

Objective This study aimed to investigate the impact of living arrangements on the risks of frailty among the oldest-old in China and whether this association vary by gender and residential location. Methods Data were obtained from the 2002-2018 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Based on questionnaire data, living arrangements were classified as living with families, living alone, or residing in an institutional care setting, including the duration of each arrangement and the composition of cohabiting family members. Frailty status was evaluated using a frailty index composed of 39 variables. The Cox proportional hazards regression model was used to assess the impact of living arrangements on the risks of frailty, with stratified analyses conducted by gender and residential location. Results In the analysis of frailty outcomes, 7 311 participants were included, with a cumulative follow-up of 32 628 person-years. There was a negative correlation between living alone and the risk of frailty (HR=0.82, 95% CI: 0.76-0.90, P < 0.001), while living in a nursing home had no significant impact on frailty risk (P=0.065). There was no significant association between the duration of living alone or in a nursing home and the risk of frailty. No significant impact of the composition of cohabiting family members on the risk of frailty was found. The stratified analysis of gender and residence found that living alone was negatively correlated with the risk of weakness in women (HR=0.79, 95% CI: 0.71-0.87, P < 0.001), and negatively correlated with the risk of weakness in urban residents (HR=0.81, 95% CI: 0.70-0.93) and rural residents (HR=0.82, 95% CI: 0.74-0.92) (all P>0.05). Living in pension institutions was only positively correlated with the risk of weakness in men (HR=1.76, 95% CI: 1.25-2.47, P < 0.001). There was no significant difference in the composition of different cohabiting family members and the risk of frailty (all P>0.05). Stratified analysis of gender and residence found that other family members in women were positively correlated with frailty risk (HR=1.37, 95% CI: 1.01-1.86, P=0.046); Other family members in urban residents were positively correlated with frailty risk (HR=1.33, 95% CI: 1.06-1.67, P=0.014). The stratified analysis of gender and residence found that living alone was negatively correlated with the risk of weakness in women (HR=0.79, 95% CI: 0.71-0.87, P < 0.001), and negatively correlated with the risk of weakness in urban residents (HR=0.81, 95% CI: 0.70-0.93) and rural residents (HR=0.82, 95% CI: 0.74-0.92) (all P>0.05). Living in pension institutions was only positively correlated with the risk of weakness in men (HR=1.76, 95% CI: 1.25-2.47, P < 0.001). There was no significant difference in the composition of different cohabiting family members and the risk of frailty (all P>0.05). Stratified analysis of gender and residence found that other family members in women were positively correlated with frailty risk (HR=1.37, 95% CI: 1.01-1.86, P=0.046); Other family members in urban residents were positively correlated with frailty risk (HR=1.33, 95% CI: 1.06-1.67, P=0.014). Conclusions Compared to those living with families members, living alone is negatively correlated with the risk of frailty, while residing in a nursing home is positively correlated with the risk of frailty, but there are gender and place of residence differences. For elderly people living in nursing homes, further assistance is needed to build and expand their social networks; For elderly people living alone, the government can further strengthen volunteer service capabilities, enhance their sense of community belonging and social support, and further promote the development of a healthy aging society in China.
- Living arrangements,
- Frailty,
- Cohort study,
- The oldest-old

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References(12)

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