{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T17:06:43Z","timestamp":1794330403403,"version":"4.9.0"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:00:00Z","timestamp":1772064000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Project 25-14 Supported by the Fundamental Research Funds for the China Institute of Sport Science","award":["Project 25-14"],"award-info":[{"award-number":["Project 25-14"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Frailty is a critical geriatric syndrome. While sedentary behavior (SB) and low lower-limb muscle power, which can be efficiently assessed by the 30-second sit-to-stand (STS) test, are independent associated factors for frailty, their additive interaction, especially in Chinese older adults, remain unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the individual and additive interactions of SB and relative sit-to-stand (STS) power with frailty, and to explore urban-rural disparities in these relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional analysis used data from 13,686 community-dwelling older adults (aged 60\u201379) from the 2024 Annual National Physical Fitness Surveillance in China. Relative STS power was assessed using the 30-second STS test and the Alcazar equation, low relative STS power was defined as a value below 2.53\u00a0W\/kg in men and below 2.01\u00a0W\/kg in women. SB was measured via the Global Physical Activity Questionnaire. Frailty was defined using the Chinese FRAIL scale. Logistic regression was used to estimate odds ratios (ORs) and additive interactions were assessed using RERI (Relative Excess Risk due to Interaction) and AP (Attributable Proportion).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of frailty was 20.4%. Both SB and low STS power were independently associated with higher frailty odds (per 1-hour SB increase: OR\u2009=\u20091.11, 95% CI: 1.09\u20131.14; per quintile decrease in STS power: OR\u2009=\u20091.08, 95% CI: 1.05\u20131.12). A significant additive interaction was found (RERI\u2009=\u20090.31, 95% CI: 0.02\u20130.59; AP\u2009=\u20090.17, 95% CI: 0.01\u20130.29), indicating that approximately 17% of the frailty prevalence in the study, can be attributed to the interaction between SB and low relative STS power. This interaction was significant in rural areas (AP\u2009=\u20090.33) but not in urban areas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prolonged SB and low relative STS power jointly increase the prevalence of frailty in an additive manner among Chinese older adults, with a more pronounced effect in rural settings. Public health interventions should concurrently target reducing sedentary time and enhancing muscle power, with tailored strategies for urban and rural populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12877-026-07230-2","type":"journal-article","created":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T00:43:10Z","timestamp":1772066590000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Frailty in Chinese older adults: the roles of sedentary behavior, relative sit-to-stand power, and their additive interaction"],"prefix":"10.1186","volume":"26","author":[{"given":"Zhu","family":"Jiarong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Jingjing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fan","family":"Chaoqun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu","family":"Yini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Mengdie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yuting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Qiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,26]]},"reference":[{"issue":"10033","key":"7230_CR1","doi-asserted-by":"publisher","first-page":"2145","DOI":"10.1016\/S0140-6736(15)00516-4","volume":"387","author":"JR Beard","year":"2016","unstructured":"Beard JR, Officer A, de Carvalho IA, et al. The World report on ageing and health: a policy framework for healthy ageing. Lancet. 2016;387(10033):2145\u201354. https:\/\/doi.org\/10.1016\/S0140-6736(15)00516-4.","journal-title":"Lancet"},{"issue":"9868","key":"7230_CR2","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1016\/S0140-6736(12)62167-9","volume":"381","author":"Frailty in Older People","year":"2013","unstructured":"Frailty in Older People. Lancet. 2013;381(9868):752\u201362. https:\/\/doi.org\/10.1016\/S0140-6736(12)62167-9.","journal-title":"Lancet"},{"issue":"7","key":"7230_CR3","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003147","volume":"17","author":"A Gil-Salcedo","year":"2020","unstructured":"Gil-Salcedo A, Dugravot A, Fayosse A, et al. Healthy behaviors at age 50 years and frailty at older ages in a 20-year follow-up of the UK Whitehall II cohort: a longitudinal study. PLoS Med. 2020;17(7):e1003147. https:\/\/doi.org\/10.1371\/journal.pmed.1003147.","journal-title":"PLoS Med"},{"issue":"7","key":"7230_CR4","doi-asserted-by":"publisher","first-page":"e323","DOI":"10.1016\/S2468-2667(18)30091-4","volume":"3","author":"P Hanlon","year":"2018","unstructured":"Hanlon P, Nicholl BI, Jani BD, Lee D, McQueenie R, Mair FS. Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493\u2008737 UK Biobank participants. Lancet Public Health. 2018;3(7):e323\u201332. https:\/\/doi.org\/10.1016\/S2468-2667(18)30091-4.","journal-title":"Lancet Public Health"},{"issue":"3","key":"7230_CR5","doi-asserted-by":"publisher","first-page":"439","DOI":"10.2307\/2061224","volume":"16","author":"JW Vaupel","year":"1979","unstructured":"Vaupel JW, Manton KG, Stallard E. The impact of heterogeneity in individual frailty on the dynamics of mortality. Demography. 1979;16(3):439\u201354.","journal-title":"Demography"},{"issue":"7","key":"7230_CR6","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaf195","volume":"54","author":"N Shen","year":"2025","unstructured":"Shen N, Yin X, Wang P, Bai H, Yin P, Liu W. The rising burden of frailty among older adults in China: evidence from the China Health and Retirement Longitudinal Study (2011\u20132020). Age Ageing. 2025;54(7):afaf195. https:\/\/doi.org\/10.1093\/ageing\/afaf195.","journal-title":"Age Ageing"},{"key":"7230_CR7","doi-asserted-by":"publisher","unstructured":"Zeng X, zhai, Meng L bing, Li Yying et al. Prevalence and factors associated with frailty and pre-frailty in the older adults in China: a national cross-sectional study. Front Public Health. 2023;11. https:\/\/doi.org\/10.3389\/fpubh.2023.1110648.","DOI":"10.3389\/fpubh.2023.1110648"},{"issue":"1","key":"7230_CR8","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1093\/gerona\/glx098","volume":"73","author":"C Wu","year":"2018","unstructured":"Wu C, Smit E, Xue QL, Odden MC. Prevalence and correlates of frailty among community-dwelling Chinese older adults: the China Health and Retirement Longitudinal Study. Journals Gerontology: Ser A. 2018;73(1):102\u20138. https:\/\/doi.org\/10.1093\/gerona\/glx098.","journal-title":"Journals Gerontology: Ser A"},{"issue":"2","key":"7230_CR9","doi-asserted-by":"publisher","DOI":"10.1097\/pp9.0000000000000013","volume":"3","author":"FB Ortega","year":"2018","unstructured":"Ortega FB, Cadenas-Sanchez C, Lee DC, Ruiz JR, Blair SN, Sui X. Fitness and fatness as health markers through the lifespan: an overview of current knowledge. Progress in Preventive Medicine. 2018;3(2):e0013. https:\/\/doi.org\/10.1097\/pp9.0000000000000013.","journal-title":"Progress in Preventive Medicine"},{"issue":"2","key":"7230_CR10","doi-asserted-by":"publisher","first-page":"1019","DOI":"10.1002\/jcsm.13184","volume":"14","author":"J Alcazar","year":"2023","unstructured":"Alcazar J, Rodriguez-Lopez C, Delecluse C, Thomis M, Van Roie E. Ten-year longitudinal changes in muscle power, force, and velocity in young, middle-aged, and older adults. J Cachexia Sarcopenia Muscle. 2023;14(2):1019\u201332. https:\/\/doi.org\/10.1002\/jcsm.13184.","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"8","key":"7230_CR11","doi-asserted-by":"publisher","first-page":"728","DOI":"10.1093\/gerona\/58.8.m728","volume":"58","author":"JF Bean","year":"2003","unstructured":"Bean JF, Leveille SG, Kiely DK, Bandinelli S, Guralnik JM, Ferrucci L. A comparison of leg power and leg strength within the InCHIANTI study: which influences mobility more? J Gerontol A Biol Sci Med Sci. 2003;58(8):728\u201333. https:\/\/doi.org\/10.1093\/gerona\/58.8.m728.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"1","key":"7230_CR12","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1097\/JES.0b013e31823b5f13","volume":"40","author":"KF Reid","year":"2012","unstructured":"Reid KF, Fielding RA. Skeletal Muscle Power: a critical determinant of physical functioning in older adults. Exerc Sport Sci Rev. 2012;40(1):4\u201312. https:\/\/doi.org\/10.1097\/JES.0b013e31823b5f13.","journal-title":"Exerc Sport Sci Rev"},{"key":"7230_CR13","doi-asserted-by":"publisher","DOI":"10.1016\/j.exger.2021.111448","volume":"152","author":"J Alcazar","year":"2021","unstructured":"Alcazar J, Aagaard P, Haddock B, et al. Assessment of functional sit-to-stand muscle power: cross-sectional trajectories across the lifespan. Exp Gerontol. 2021;152:111448. https:\/\/doi.org\/10.1016\/j.exger.2021.111448.","journal-title":"Exp Gerontol"},{"issue":"1","key":"7230_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.22540\/JFSF-08-001","volume":"8","author":"CM Burbank","year":"2023","unstructured":"Burbank CM, Branscum A, Bovbjerg ML, Hooker K, Smit E. Muscle power predicts frailty status over four years: a retrospective cohort study of the National Health and Aging Trends Study. J Frailty Sarcopenia Falls. 2023;8(1):1\u20138. https:\/\/doi.org\/10.22540\/JFSF-08-001.","journal-title":"J Frailty Sarcopenia Falls"},{"issue":"4","key":"7230_CR15","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1093\/gerona\/glab230","volume":"77","author":"J Losa-Reyna","year":"2022","unstructured":"Losa-Reyna J, Alcazar J, Carnicero J, et al. Impact of relative muscle power on hospitalization and all-cause mortality in older adults. J Gerontol A Biol Sci Med Sci. 2022;77(4):781\u20139. https:\/\/doi.org\/10.1093\/gerona\/glab230.","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"7230_CR16","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.exger.2018.08.006","volume":"112","author":"J Alcazar","year":"2018","unstructured":"Alcazar J, Losa-Reyna J, Rodriguez-Lopez C, et al. The sit-to-stand muscle power test: an easy, inexpensive and portable procedure to assess muscle power in older people. Exp Gerontol. 2018;112:38\u201343. https:\/\/doi.org\/10.1016\/j.exger.2018.08.006.","journal-title":"Exp Gerontol"},{"issue":"11","key":"7230_CR17","doi-asserted-by":"publisher","first-page":"2217","DOI":"10.1249\/MSS.0000000000002717","volume":"53","author":"J Alcazar","year":"2021","unstructured":"Alcazar J, Alegre LM, Suetta C, et al. Threshold of relative muscle power required to rise from a chair and mobility limitations and disability in older adults. Med Sci Sports Exerc. 2021;53(11):2217. https:\/\/doi.org\/10.1249\/MSS.0000000000002717.","journal-title":"Med Sci Sports Exerc"},{"key":"7230_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jshs.2025.101080","volume":"15","author":"M Garcia-Aguirre","year":"2025","unstructured":"Garcia-Aguirre M, Baltasar-Fernandez I, Alcazar J, et al. Low relative sit-to-stand power is associated with history of falls and fractures, prospective hospitalization, and all-cause mortality in older adults from the Toledo study for healthy aging. J Sport Health Sci. 2025;101080. https:\/\/doi.org\/10.1016\/j.jshs.2025.101080.","journal-title":"J Sport Health Sci"},{"issue":"1","key":"7230_CR19","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13676","volume":"16","author":"M Garcia-Aguirre","year":"2025","unstructured":"Garcia-Aguirre M, Baltasar-Fernandez I, Alcazar J, et al. Cut-off points for low relative 30-s sit-to-stand power and their associations with adverse health conditions. J Cachexia Sarcopenia Muscle. 2025;16(1):e13676. https:\/\/doi.org\/10.1002\/jcsm.13676.","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"24","key":"7230_CR20","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","volume":"54","author":"FC Bull","year":"2020","unstructured":"Bull FC, Al-Ansari SS, Biddle S, et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020;54(24):1451\u201362. https:\/\/doi.org\/10.1136\/bjsports-2020-102955.","journal-title":"Br J Sports Med"},{"key":"7230_CR21","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104563","volume":"146","author":"J Wu","year":"2023","unstructured":"Wu J, Fu Y, Chen D, et al. Sedentary behavior patterns and the risk of non-communicable diseases and all-cause mortality: a systematic review and meta-analysis. Int J Nurs Stud. 2023;146:104563. https:\/\/doi.org\/10.1016\/j.ijnurstu.2023.104563.","journal-title":"Int J Nurs Stud"},{"issue":"8","key":"7230_CR22","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1161\/CIRCULATIONAHA.118.035312","volume":"139","author":"J Bellettiere","year":"2019","unstructured":"Bellettiere J, LaMonte MJ, Evenson KR, et al. Sedentary behavior and cardiovascular disease in older women. Circulation. 2019;139(8):1036\u201346. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.118.035312.","journal-title":"Circulation"},{"issue":"2","key":"7230_CR23","doi-asserted-by":"publisher","first-page":"563","DOI":"10.2337\/dc20-0709","volume":"44","author":"J Bellettiere","year":"2020","unstructured":"Bellettiere J, LaMonte MJ, Healy GN, et al. Sedentary behavior and diabetes risk among women over the age of 65 years: the OPACH study. Diabetes Care. 2020;44(2):563\u201370. https:\/\/doi.org\/10.2337\/dc20-0709.","journal-title":"Diabetes Care"},{"issue":"6","key":"7230_CR24","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1139\/apnm-2018-0092","volume":"43","author":"DS Kehler","year":"2018","unstructured":"Kehler DS. The impact of sedentary and physical activity behaviour on frailty in middle-aged and older adults. Appl Physiol Nutr Metab. 2018;43(6):638\u2013638. https:\/\/doi.org\/10.1139\/apnm-2018-0092.","journal-title":"Appl Physiol Nutr Metab"},{"key":"7230_CR25","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7062-0","volume":"19","author":"VD da Silva","year":"2019","unstructured":"da Silva VD, Tribess S, Meneguci J, et al. Association between frailty and the combination of physical activity level and sedentary behavior in older adults. BMC Public Health. 2019;19:709. https:\/\/doi.org\/10.1186\/s12889-019-7062-0.","journal-title":"BMC Public Health"},{"issue":"1","key":"7230_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/s11556-023-00324-5","volume":"20","author":"WN Chang","year":"2023","unstructured":"Chang WN, Tzeng PL, Huang WJ, et al. Objective assessment of the association between frailty and sedentary behavior in older adults: a cross-sectional study. Eur Rev Aging Phys Act. 2023;20(1):14. https:\/\/doi.org\/10.1186\/s11556-023-00324-5.","journal-title":"Eur Rev Aging Phys Act"},{"issue":"6","key":"7230_CR27","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/S2213-8587(16)00081-4","volume":"4","author":"Y Tian","year":"2016","unstructured":"Tian Y, Jiang C, Wang M, et al. BMI, leisure-time physical activity, and physical fitness in adults in China: results from a series of national surveys, 2000-14. The Lancet Diabetes & Endocrinology. 2016;4(6):487\u201397. https:\/\/doi.org\/10.1016\/S2213-8587(16)00081-4.","journal-title":"The Lancet Diabetes & Endocrinology"},{"key":"7230_CR28","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanwpc.2025.101542","volume":"57","author":"C Qin","year":"2025","unstructured":"Qin C, Fan C, Wang J, et al. Trends and inequalities in physical fitness and nutritional status among 0.72\u00a0million Chinese adults aged 20\u201359 years: an analysis of five successive national surveillance surveys, 2000\u20132020. The Lancet Regional Health - Western Pacific. 2025;57:101542. https:\/\/doi.org\/10.1016\/j.lanwpc.2025.101542.","journal-title":"The Lancet Regional Health - Western Pacific"},{"issue":"3","key":"7230_CR29","doi-asserted-by":"publisher","first-page":"606","DOI":"10.12290\/xhyxzz.2025-0227","volume":"16","author":"ZHU Jiarong","year":"2025","unstructured":"Jiarong ZHU, Jingjing W, Chaoqun F, Xu Z, Qiang F. Current status and correlated factors of fall risk among Chinese elderly aged 60\u201379: a 2024 nationwide cross-sectional analysis. xhyxzz. 2025;16(3):606\u201316. https:\/\/doi.org\/10.12290\/xhyxzz.2025-0227.","journal-title":"xhyxzz"},{"key":"7230_CR30","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-73395-4","volume":"10","author":"J Alcazar","year":"2020","unstructured":"Alcazar J, Kamper RS, Aagaard P, et al. Relation between leg extension power and 30-s sit-to-stand muscle power in older adults: validation and translation to functional performance. Sci Rep. 2020;10:16337. https:\/\/doi.org\/10.1038\/s41598-020-73395-4.","journal-title":"Sci Rep"},{"issue":"1","key":"7230_CR31","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.13676","volume":"16","author":"M Garcia-Aguirre","year":"2025","unstructured":"Garcia-Aguirre M, Baltasar\u2010Fernandez I, Alcazar J, et al. Cut\u2010off points for low relative 30\u2010s sit\u2010to\u2010stand power and their associations with adverse health conditions. J Cachexia Sarcopenia Muscle. 2025;16(1):e13676. https:\/\/doi.org\/10.1002\/jcsm.13676.","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"7230_CR32","unstructured":"WHO. Global Physical Activity Questionnaire (GPAQ). analysis guide. https:\/\/cdn.who.int\/media\/docs\/default-source\/ncds\/ncd-surveillance\/gpaq-analysis-guide.pdf (accessed December 10, 2025). Accessed December 10, 2025. https:\/\/cdn.who.int\/media\/docs\/default-source\/ncds\/ncd-surveillance\/gpaq-analysis-guide.pdf"},{"issue":"8","key":"7230_CR33","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1111\/jcpe.13669","volume":"49","author":"M Almohamad","year":"2022","unstructured":"Almohamad M, Krall Kaye E, Mofleh D, Spartano NL. The association of sedentary behaviour and physical activity with periodontal disease in NHANES 2011\u20132012. J Clin Periodontol. 2022;49(8):758\u201367. https:\/\/doi.org\/10.1111\/jcpe.13669.","journal-title":"J Clin Periodontol"},{"issue":"8","key":"7230_CR34","doi-asserted-by":"publisher","first-page":"714.e7","DOI":"10.1016\/j.jamda.2015.05.019","volume":"16","author":"Y Li","year":"2015","unstructured":"Li Y, Zou Y, Wang S, et al. A pilot study of the FRAIL scale on predicting outcomes in Chinese elderly people with type 2 diabetes. J Am Med Dir Assoc. 2015;16(8):714.e7-714.e12. https:\/\/doi.org\/10.1016\/j.jamda.2015.05.019.","journal-title":"J Am Med Dir Assoc"},{"issue":"1","key":"7230_CR35","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.jamda.2017.06.011","volume":"19","author":"L Dong","year":"2018","unstructured":"Dong L, Qiao X, Tian X, Jin Y, Si H, Wang C. Cross-cultural adaptation and validation of the FRAIL scale in Chinese community-dwelling older adults. J Am Med Dir Assoc. 2018;19(1):12\u20137. https:\/\/doi.org\/10.1016\/j.jamda.2017.06.011.","journal-title":"J Am Med Dir Assoc"},{"issue":"3","key":"7230_CR36","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.annepidem.2006.10.009","volume":"17","author":"R Li","year":"2007","unstructured":"Li R, Chambless L. Test for additive interaction in proportional hazards models. Ann Epidemiol. 2007;17(3):227\u201336. https:\/\/doi.org\/10.1016\/j.annepidem.2006.10.009.","journal-title":"Ann Epidemiol"},{"issue":"7","key":"7230_CR37","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s10654-005-7835-x","volume":"20","author":"T Andersson","year":"2005","unstructured":"Andersson T, Alfredsson L, K\u00e4llberg H, Zdravkovic S, Ahlbom A. Calculating measures of biological interaction. Eur J Epidemiol. 2005;20(7):575\u20139. https:\/\/doi.org\/10.1007\/s10654-005-7835-x.","journal-title":"Eur J Epidemiol"},{"key":"7230_CR38","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2393","volume":"338","author":"JAC Sterne","year":"2009","unstructured":"Sterne JAC, White IR, Carlin JB, et al. Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls. BMJ. 2009;338:b2393. https:\/\/doi.org\/10.1136\/bmj.b2393.","journal-title":"BMJ"},{"issue":"4","key":"7230_CR39","doi-asserted-by":"publisher","first-page":"268","DOI":"10.7326\/M16-2607","volume":"167","author":"TJ VanderWeele","year":"2017","unstructured":"VanderWeele TJ, Ding P. Sensitivity analysis in observational research: introducing the E-value. Ann Intern Med. 2017;167(4):268\u201374. https:\/\/doi.org\/10.7326\/M16-2607.","journal-title":"Ann Intern Med"},{"issue":"12","key":"7230_CR40","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1016\/j.tem.2022.09.002","volume":"33","author":"NR Kerr","year":"2022","unstructured":"Kerr NR, Booth FW. Contributions of physical inactivity and sedentary behavior to metabolic and endocrine diseases. Trends Endocrinol Metab. 2022;33(12):817\u201327. https:\/\/doi.org\/10.1016\/j.tem.2022.09.002.","journal-title":"Trends Endocrinol Metab"},{"key":"7230_CR41","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.625950","author":"O Bergens","year":"2021","unstructured":"Bergens O, Nilsson A, Papaioannou KG, Kadi F. Sedentary patterns and systemic inflammation: sex-specific links in older adults. Front Physiol. 2021. https:\/\/doi.org\/10.3389\/fphys.2021.625950.","journal-title":"Front Physiol"},{"issue":"2","key":"7230_CR42","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.amepre.2011.05.004","volume":"41","author":"AA Thorp","year":"2011","unstructured":"Thorp AA, Owen N, Neuhaus M, Dunstan DW. Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996\u20132011. Am J Prev Med. 2011;41(2):207\u201315. https:\/\/doi.org\/10.1016\/j.amepre.2011.05.004.","journal-title":"Am J Prev Med"},{"issue":"6","key":"7230_CR43","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.1007\/s00125-018-4603-5","volume":"61","author":"KA Bowden Davies","year":"2018","unstructured":"Bowden Davies KA, Sprung VS, Norman JA, et al. Short-term decreased physical activity with increased sedentary behaviour causes metabolic derangements and altered body composition: effects in individuals with and without a first-degree relative with type 2 diabetes. Diabetologia. 2018;61(6):1282\u201394. https:\/\/doi.org\/10.1007\/s00125-018-4603-5.","journal-title":"Diabetologia"},{"issue":"3","key":"7230_CR44","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1007\/s00125-016-4161-7","volume":"60","author":"BMFM Duvivier","year":"2017","unstructured":"Duvivier BMFM, Schaper NC, Hesselink MKC, et al. Breaking sitting with light activities vs structured exercise: a randomised crossover study demonstrating benefits for glycaemic control and insulin sensitivity in type 2 diabetes. Diabetologia. 2017;60(3):490\u20138. https:\/\/doi.org\/10.1007\/s00125-016-4161-7.","journal-title":"Diabetologia"},{"issue":"1","key":"7230_CR45","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1007\/s12160-017-9921-1","volume":"52","author":"S Park","year":"2018","unstructured":"Park S, Th\u00f8gersen-Ntoumani C, van Veldhuijzen Zanten JJCS, Ntoumanis N. The role of physical activity and sedentary behavior in predicting daily pain and fatigue in older adults: a diary study. Ann Behav Med. 2018;52(1):19\u201328. https:\/\/doi.org\/10.1007\/s12160-017-9921-1.","journal-title":"Ann Behav Med"},{"issue":"1","key":"7230_CR46","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1002\/jcsm.13141","volume":"14","author":"M Guo","year":"2023","unstructured":"Guo M, Yao J, Li J, et al. Irisin ameliorates age-associated sarcopenia and metabolic dysfunction. J Cachexia Sarcopenia Muscle. 2023;14(1):391\u2013405. https:\/\/doi.org\/10.1002\/jcsm.13141.","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"2","key":"7230_CR47","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1109\/TBME.1987.326037","volume":"BME-34","author":"BH Zhou","year":"1987","unstructured":"Zhou BH, Baratta R, Solomonow M. Manipulation of muscle force with various firing rate and recruitment control strategies. IEEE Trans Biomed Eng. 1987;BME-34(2):128\u201339. https:\/\/doi.org\/10.1109\/TBME.1987.326037.","journal-title":"IEEE Trans Biomed Eng"},{"issue":"4","key":"7230_CR48","doi-asserted-by":"publisher","DOI":"10.3390\/jfmk9040195","volume":"9","author":"Y Concha-Cisternas","year":"2024","unstructured":"Concha-Cisternas Y, Castro-Pi\u00f1ero J, V\u00e1squez-Mu\u00f1oz M, Molina-M\u00e1rquez I, V\u00e1squez-G\u00f3mez J, Guzm\u00e1n-Mu\u00f1oz E. Effects of neuromuscular training on postural balance and physical performance in older women: randomized controlled trial. J Funct Morphol Kinesiol. 2024;9(4):195. https:\/\/doi.org\/10.3390\/jfmk9040195.","journal-title":"J Funct Morphol Kinesiol"},{"issue":"3","key":"7230_CR49","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s40520-015-0448-7","volume":"28","author":"MH Morcelli","year":"2016","unstructured":"Morcelli MH, LaRoche DP, Crozara LF, et al. Neuromuscular performance in the hip joint of elderly fallers and non-fallers. Aging Clin Exp Res. 2016;28(3):443\u201350. https:\/\/doi.org\/10.1007\/s40520-015-0448-7.","journal-title":"Aging Clin Exp Res"},{"issue":"5","key":"7230_CR50","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1093\/oxfordjournals.aje.a116536","volume":"136","author":"GS Sorock","year":"1992","unstructured":"Sorock GS, Labiner DM. Peripheral neuromuscular dysfunction and falls in an elderly cohort. Am J Epidemiol. 1992;136(5):584\u201391. https:\/\/doi.org\/10.1093\/oxfordjournals.aje.a116536.","journal-title":"Am J Epidemiol"},{"issue":"3","key":"7230_CR51","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1016\/j.jamda.2020.09.044","volume":"22","author":"Y Seo","year":"2021","unstructured":"Seo Y, Kim M, Shim H, Won CW. Differences in the association of neighborhood environment with physical frailty between urban and rural older adults: the Korean Frailty and Aging Cohort Study (KFACS). J Am Med Dir Assoc. 2021;22(3):590-597.e1. https:\/\/doi.org\/10.1016\/j.jamda.2020.09.044.","journal-title":"J Am Med Dir Assoc"},{"issue":"1","key":"7230_CR52","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246275","volume":"16","author":"CAG Meneguci","year":"2021","unstructured":"Meneguci CAG, Meneguci J, Sasaki JE, Tribess S, J\u00fanior JSV. Physical activity, sedentary behavior and functionality in older adults: a cross-sectional path analysis. PLoS One. 2021;16(1):e0246275. https:\/\/doi.org\/10.1371\/journal.pone.0246275.","journal-title":"PLoS One"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-026-07230-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07230-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-026-07230-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:53:38Z","timestamp":1781636018000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12877-026-07230-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,26]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["7230"],"URL":"https:\/\/doi.org\/10.1186\/s12877-026-07230-2","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,26]]},"assertion":[{"value":"20 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study protocol has been approved by the ethical review committee of the China Institute of Sport Science (CISSLA-20240209). All participants provided written informed consent prior to their participation in the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of this institutional committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"450"}}