{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:30:58Z","timestamp":1790220658483,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012151","name":"Sanming Project of Medicine in Shenzen Municipality","doi-asserted-by":"publisher","award":["SZZYSM202311004"],"award-info":[{"award-number":["SZZYSM202311004"]}],"id":[{"id":"10.13039\/501100012151","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Geriatrics Gerontology Int"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Frailty reflects a decline in physiological reserve and has been widely recognized as an important risk factor for cardiovascular disease (CVD). However, the relationships between frailty and the progression of the cardiovascular\u2013kidney\u2013metabolic (CKM) syndrome, as well as between dynamic frailty trajectories and CVD risk, have not been systematically investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 5624 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included. The association between baseline frailty and CVD risk was analyzed using the Cox proportional hazards model and the restricted cubic spline analyses. We used Group\u2010based trajectory modeling (GBTM) to identify trajectories of frailty development during the follow\u2010up periods from 2011 to 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Higher baseline frailty index (FI) was significantly associated with CVD risk in individuals with CKM syndrome stages 0\u20133; each 0.1 increase in FI was associated with a 33% higher risk of CVD after full adjustment (HR 1.33, 95% CI 1.26\u20131.40). Cumulative frailty burden, assessed using the cumulative FI (cumFI), showed a strong graded association with CVD risk. Three distinct frailty trajectories were identified. Compared with the low\u2010level increasing trajectory, moderate\u2010level and high\u2010level increasing trajectories were associated with higher CVD risk (HR\u2009=\u20094.63, 95% CI: 3.50\u20136.14, HR\u2009=\u20099.33, 95% CI: 6.89\u201312.64). These associations were consistent across multiple sensitivity analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Frailty is associated with the risk of CKM syndrome progression. Beyond baseline assessment, cumFI and frailty trajectories provide prognostic information for cardiovascular risk. Dynamic assessment and early intervention targeting frailty may offer a strategy for preventing CVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ggi.70627","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T05:08:06Z","timestamp":1783055286000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association of Frailty and Its Trajectories With the Risk of Cardiovascular\u2013Kidney\u2013Metabolic Syndrome Progression: A Longitudinal Cohort Study"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8266-1880","authenticated-orcid":false,"given":"Haoyu","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Nephrology Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongli","family":"Wang","sequence":"additional","affiliation":[{"name":"Medical College of Acu\u2010Moxi and Rehabilitation Guangzhou University of Chinese Medicine  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wuyong","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Nephrology Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Men","sequence":"additional","affiliation":[{"name":"Department of Nephrology Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5764-5534","authenticated-orcid":false,"given":"Riming","family":"He","sequence":"additional","affiliation":[{"name":"Department of Nephrology Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1302-0978","authenticated-orcid":false,"given":"Shudong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Nephrology Shenzhen Traditional Chinese Medicine Hospital, the Fourth Clinical Medical College of Guangzhou University of Chinese Medicine  Shenzhen China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.31083\/j.rcm2304135"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001184"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaf250"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpcardiol.2023.102344"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2006.05.019"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13047"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad885"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14176008"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-025-61089-2"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-025-02928-6"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-023-2037-3"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys203"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-025-02589-9"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2318-8-24"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(20)30113-4"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacadv.2025.101843"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.699579"},{"issue":"4","key":"e_1_2_11_19_1","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","year":"2024","journal-title":"Kidney International"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-025-05752-9"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2025.102696"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11357-020-00247-4"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells12121640"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00928"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mad.2019.01.004"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glab315"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1920795117"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.publhealth.26.021304.144505"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1284-y"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2024.112504"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1407-5"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-018-0064-2"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-025-02784-8"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2025.119606"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaf248"}],"container-title":["Geriatrics &amp; Gerontology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70627","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ggi.70627","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ggi.70627","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:02:02Z","timestamp":1788786122000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ggi.70627"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":34,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/ggi.70627"],"URL":"https:\/\/doi.org\/10.1111\/ggi.70627","archive":["Portico"],"relation":{},"ISSN":["1444-1586","1447-0594"],"issn-type":[{"value":"1444-1586","type":"print"},{"value":"1447-0594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70627"}}