{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T17:46:42Z","timestamp":1782928002032,"version":"3.54.5"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","funder":[{"name":"Intramural Research Program of the National Institutes of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Upper gastrointestinal (GI) disorders\u2014including gastroesophageal reflux disorder, peptic ulcer disease, and gastritis\u2014are common with aging, yet their contribution to frailty burden and progression is poorly understood. This study investigated whether upper GI disorders are independently associated with frailty in the Baltimore Longitudinal Study of Aging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from 1353 participants (mean age 65.6\u2009years; 47.7% men) with documented upper GI disorder status and Frailty Index (FI). Cross-sectional associations were examined using linear regression adjusted for age, sex, race, education, body mass index (BMI), and smoking. Longitudinal trajectories of FI were analyzed in a subset with \u22653 follow-up visits (n\u2009=\u2009749) using linear mixed-effects models. Sensitivity analyses were conducted after excluding participants whose diagnosis occurred more than 1\u2009year before FI assessment and for older adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Upper GI disorders were significantly associated with higher frailty burden in cross-sectional analyses (\u03b2\u2009=\u20090.0303, p\u2009=\u20091.13\u2009\u00d7\u200910\u221211). Older age, higher BMI, and lower educational attainment were also associated with higher FI. Longitudinal analyses further demonstrated that upper GI disorders were a significant predictor of FI throughout the follow-up period (\u03b2\u2009=\u20090.018, p\u2009=\u20094.3\u2009\u00d7\u200910\u22129). However, the rate of frailty progression did not differ significantly between participants with and without GI disorders. Associations remained robust in all sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Upper GI disorders were associated with higher frailty burden and greater degree of frailty that persisted over time, independent of covariates. Further research may be needed to explore the specific mechanisms through which upper GI disorders influence frailty.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/gerona\/glag148","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:32:42Z","timestamp":1781004762000},"source":"Crossref","is-referenced-by-count":0,"title":["The impact of upper gastrointestinal disorders on frailty: insights from the Baltimore Longitudinal Study of Aging"],"prefix":"10.1093","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9420-0043","authenticated-orcid":false,"given":"Balewgizie S","family":"Tegegne","sequence":"first","affiliation":[{"name":"Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging Intramural Program, National Institutes of Health , Baltimore, Maryland,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Gupta","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health , Baltimore, Maryland,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6273-1613","authenticated-orcid":false,"given":"Luigi","family":"Ferrucci","sequence":"additional","affiliation":[{"name":"Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging Intramural Program, National Institutes of Health , Baltimore, Maryland,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4161-3829","authenticated-orcid":false,"given":"Toshiko","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging Intramural Program, National Institutes of Health , Baltimore, Maryland,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026070112575667600_glag148-B1","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","article-title":"Frailty in elderly people","volume":"381","author":"Clegg","year":"2013","journal-title":"Lancet"},{"key":"2026070112575667600_glag148-B2","doi-asserted-by":"publisher","first-page":"6757524","DOI":"10.1155\/2019\/6757524","article-title":"Gastrointestinal tract disorders in older age","volume":"2019","author":"Dumic","year":"2019","journal-title":"Can J Gastroenterol Hepatol"},{"key":"2026070112575667600_glag148-B3","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1053\/j.gastro.2024.12.029","article-title":"Burden and cost of gastrointestinal, liver, and pancreatic diseases in the United States: update 2024","volume":"168","author":"Peery","year":"2025","journal-title":"Gastroenterology"},{"key":"2026070112575667600_glag148-B4","doi-asserted-by":"publisher","first-page":"8916","DOI":"10.1038\/s41598-025-93114-1","article-title":"Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study","volume":"15","author":"Peng","year":"2025","journal-title":"Sci Rep"},{"key":"2026070112575667600_glag148-B5","doi-asserted-by":"publisher","first-page":"101807","DOI":"10.1016\/j.eclinm.2022.101807","article-title":"Frailty status and risk of irritable bowel syndrome in middle-aged and older adults: a large-scale prospective cohort study","volume":"56","author":"Wu","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2026070112575667600_glag148-B6","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1016\/j.archger.2014.02.008","article-title":"Clinical features of prefrail older individuals and emerging peripheral biomarkers: a systematic review","volume":"59","author":"Fernandez-Garrido","year":"2014","journal-title":"Arch Gerontol Geriatr"},{"key":"2026070112575667600_glag148-B7","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1111\/j.1749-6632.2000.tb06651.x","article-title":"Inflamm-aging. 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