{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:51:52Z","timestamp":1787165512070,"version":"build-2736575974"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T00:00:00Z","timestamp":1765843200000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2009600"],"award-info":[{"award-number":["2022YFC2009600"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC2009601"],"award-info":[{"award-number":["2022YFC2009601"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although frailty has been identified as a potential risk factor for cancer, most previous studies have only considered frailty status at a single time point. The relationship between dynamic changes in frailty and incident cancer is less well understood. This study aimed to evaluate the associations of both baseline frailty status and changes in frailty status with subsequent cancer risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were derived from the Health and Retirement Study (HRS), a nationally representative prospective cohort in the United States. Frailty was assessed using a 29\u2010item Rockwood frailty index and categorized as robust, pre\u2010frail or frail. Changes in frailty status were determined over a 2\u2010year period. Incident cancer was identified through self\u2010reported physician diagnoses. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for demographic, lifestyle and health\u2010related covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 11\u2009661 participants (63.1% female; mean age: 67.1\u2009years) were included in the baseline frailty analysis, and 10\u2009178 participants (63.8% female; mean age: 66.3\u2009years) were included in the frailty change analysis. During a median follow\u2010up of 7.2\u2009years, baseline frailty was associated with a significantly increased risk of incident cancer (frail vs. robust: HR 1.61, 95% CI 1.27\u20132.02; pre\u2010frail vs. robust: HR 1.46, 95% CI 1.17\u20131.83). Over the 2\u2010year transition period, participants who progressed from robust to pre\u2010frail\/frail status had a higher cancer risk compared to those who remained robust (HR 2.50, 95% CI 1.74\u20133.61). Conversely, frail individuals who improved to pre\u2010frail or robust status had a reduced cancer risk relative to those who remained frail (HR 0.66, 95% CI 0.48\u20130.90). Similar risk reduction was observed among pre\u2010frail individuals who recovered to robust status (HR 0.51, 95% CI 0.34\u20130.76). Additionally, greater increases in frailty index over timeremained associated with elevated cancer risk after multivariable adjustment (highest vs. lowest quartile of \u0394FI: HR 1.35, 95% CI 1.13\u20131.63;\n                      <jats:italic>p<\/jats:italic>\n                      for trend &lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both baseline frailty and changes in frailty status are independently associated with cancer risk. Frailty progression significantly increases the risk of incident cancer, whereas recovery from frailty is associated with reduced risk. These findings underscore the importance of dynamic frailty monitoring and suggest that interventions targeting frailty warrant investigation for potential cancer risk reduction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jcsm.70164","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T16:11:22Z","timestamp":1765901482000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changes in Frailty and Incident Cancer: Evidence From the Health and Retirement Study"],"prefix":"10.1002","volume":"16","author":[{"given":"Zhaoting","family":"Bu","sequence":"first","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyue","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bing","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanyu","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Department of Clinical Oncology, LKS Faculty of Medicine, the University of Hong Kong  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangrui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory of Cancer FSMP for State Market Regulation  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4514-8693","authenticated-orcid":false,"given":"Hanping","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Clinical Nutrition Beijing Shijitan Hospital, Capital Medical University  Beijing China"},{"name":"Center for Clinical Nutrition and Department of Colorectal Surgery, The First Affiliated Hospital of Wenzhou Medical University  Wenzhou Zhejiang China"},{"name":"Key Laboratory 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M.","year":"2023","journal-title":"Precision Nutrition"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2022.7052"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-025-22959-y"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1017183"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.17599"},{"key":"e_1_2_10_20_1","article-title":"A Prospective Birth Cohort Study of Maternal Prenatal Cigarette Smoking Assessed by Self\u2010Report and Biomarkers on Childhood Risk of Overweight or Obesity","volume":"1","author":"Hou W.","year":"2022","journal-title":"Precision Nutrition"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1039\/D4FO02360A"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02774-1"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.35511"}],"container-title":["Journal of Cachexia, Sarcopenia and Muscle"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jcsm.70164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jcsm.70164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T08:40:56Z","timestamp":1772959256000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jcsm.70164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":22,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1002\/jcsm.70164"],"URL":"https:\/\/doi.org\/10.1002\/jcsm.70164","archive":["Portico"],"relation":{},"ISSN":["2190-5991","2190-6009"],"issn-type":[{"value":"2190-5991","type":"print"},{"value":"2190-6009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]},"assertion":[{"value":"2025-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70164"}}