{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:19:27Z","timestamp":1790349567631,"version":"4.1.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Previous studies primarily focused on baseline sarcopenia status, neglecting changes over time. This study aims to explore the association between changes in sarcopenia status and frailty progression, hypothesizing that transitions to possible sarcopenia or sarcopenia increase frailty risk, while recovery to non-sarcopenia reduces this risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the China Health and Retirement Longitudinal Study (CHARLS), sarcopenia was evaluated at baseline and after 2 years using the AWGS 2019 criteria. Frailty was assessed with a 32-item frailty index. Cox regression and linear mixed models analyzed the association between sarcopenia transitions and frailty progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Participants who developed possible sarcopenia or sarcopenia faced a 56% higher frailty risk (HR 1.56, 95% CI 1.21\u20132.01) and a faster frailty index increase (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f0.007\/year, 95% CI 0.005\u20130.010) compared to those remaining non-sarcopenic. In contrast, those recovering from sarcopenia to non-sarcopenia or possible sarcopenia had a 46% lower frailty risk (HR 0.54, 95% CI 0.32\u20130.89) and a slower frailty index rise (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      =\u202f\u22120.008\/year, 95% CI \u20130.015 to \u22120.002). Among individuals with possible sarcopenia at baseline, recovery to non-sarcopenia reduced frailty risk by 48% (HR 0.52, 95% CI 0.39\u20130.68), while progression to sarcopenia increased it by 77% (HR 1.77, 95% CI 1.07\u20132.94).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Transitions in sarcopenia status significantly affect frailty risk and progression. Worsening sarcopenia heightens frailty risk, whereas recovery diminishes it. These findings highlight the value of monitoring and addressing sarcopenia in middle-aged and older adults, offering potential to enhance quality of life and lower healthcare costs through targeted interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1551282","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T05:29:45Z","timestamp":1767590985000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Sarcopenia and the frailty progression among Chinese: a longitudinal study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xingyu","family":"Mu","sequence":"first","affiliation":[{"name":"General Practice Ward, International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingyue","family":"Zeng","sequence":"additional","affiliation":[{"name":"General Practice Ward, International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xijie","family":"Yu","sequence":"additional","affiliation":[{"name":"Laboratory of Endocrinology and Metabolism, Department of Endocrinology and Metabolism, Rare Disease Center, West China Hospital, Sichuan University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangqing","family":"Li","sequence":"additional","affiliation":[{"name":"General Practice Ward, International Medical Center Ward, General Practice Medical Center, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University","place":["Chengdu, Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,5]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"956","DOI":"10.1002\/jcsm.12483","article-title":"Sarcopenia: a time for action. An SCWD position paper","volume":"10","author":"Bauer","year":"2019","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","article-title":"Sarcopenia","volume":"393","author":"Cruz-Jentoft","year":"2019","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"102111","DOI":"10.1016\/j.arr.2023.102111","article-title":"Frailty and sarcopenia: a bibliometric analysis of their association and potential targets for intervention","volume":"92","author":"Ye","year":"2023","journal-title":"Ageing Res Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"155638","DOI":"10.1016\/j.metabol.2023.155638","article-title":"Sarcopenia, osteoporosis and frailty","volume":"145","author":"Gielen","year":"2023","journal-title":"Metabolism"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.arr.2017.01.006","article-title":"Frailty and sarcopenia: the potential role of an aged immune system","volume":"36","author":"Wilson","year":"2017","journal-title":"Ageing Res Rev"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"748","DOI":"10.1093\/ageing\/afu115","article-title":"Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the international sarcopenia initiative (EWGSOP and IWGS)","volume":"43","author":"Cruz-Jentoft","year":"2014","journal-title":"Age Ageing"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2618","DOI":"10.1002\/jcp.25001","article-title":"Determinants of muscle and bone aging","volume":"230","author":"Curtis","year":"2015","journal-title":"J Cell Physiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1093\/ageing\/afac220","article-title":"Sarcopenia definition, diagnosis and treatment: consensus is growing","volume":"51","author":"Sayer","year":"2022","journal-title":"Age Ageing"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1002\/jcsm.13275","article-title":"Association between sarcopenia and frailty in elderly patients with chronic kidney disease","volume":"14","author":"Wang","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"2352","DOI":"10.1002\/jcsm.13055","article-title":"Role of sarcopenia in the frailty transitions in older adults: a population-based cohort study","volume":"13","author":"\u00c1lvarez-Bustos","year":"2022","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"e00102","DOI":"10.14309\/ctg.0000000000000102","article-title":"Sex differences in the association between frailty and sarcopenia in patients with cirrhosis","volume":"10","author":"Fozouni","year":"2019","journal-title":"Clin Transl Gastroenterol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1817","DOI":"10.1007\/s00198-017-3980-9","article-title":"Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review","volume":"28","author":"Beaudart","year":"2017","journal-title":"Osteoporos Int"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1186\/s12877-021-02642-8","article-title":"Effects of different exercise training modes on muscle strength and physical performance in older people with sarcopenia: a systematic review and meta-analysis","volume":"21","author":"Lu","year":"2021","journal-title":"BMC Geriatr"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China health and retirement longitudinal study (CHARLS)","volume":"43","author":"Zhao","year":"2014","journal-title":"Int J Epidemiol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1002\/jcsm.12163","article-title":"Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study","volume":"8","author":"Yang","year":"2017","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1007\/s12603-014-0540-2","article-title":"Sarcopenia according to the European working group on sarcopenia in older people (EWGSOP) versus dynapenia as a risk factor for mortality in the elderly","volume":"18","author":"Alexandre Tda","year":"2014","journal-title":"J Nutr Health Aging"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e0247617","DOI":"10.1371\/journal.pone.0247617","article-title":"Sarcopenia prevalence and associated factors among older Chinese population: findings from the China health and retirement longitudinal study","volume":"16","author":"Wu","year":"2021","journal-title":"PLoS One"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"112494","DOI":"10.1016\/j.exger.2024.112494","article-title":"Associations between modifiable risk factors and frailty progression among individuals with pre-frailty","volume":"194","author":"Duan","year":"2024","journal-title":"Exp Gerontol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/1471-2318-8-24","article-title":"A standard procedure for creating a frailty index","volume":"8","author":"Searle","year":"2008","journal-title":"BMC Geriatr"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"302","DOI":"10.1186\/s12933-024-02379-9","article-title":"Association of metabolic syndrome severity with frailty progression among Chinese middle and old-aged adults: a longitudinal study","volume":"23","author":"Zeng","year":"2024","journal-title":"Cardiovasc Diabetol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2583","DOI":"10.1093\/eurheartj\/ehad306","article-title":"Joint association of loneliness and traditional risk factor control and incident cardiovascular disease in diabetes patients","volume":"44","author":"Wang","year":"2023","journal-title":"Eur Heart J"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1684","DOI":"10.1016\/j.scib.2021.02.018","article-title":"Low levels of low-density lipoprotein cholesterol and cognitive decline","volume":"66","author":"Hua","year":"2021","journal-title":"Sci Bull"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"3041","DOI":"10.1016\/j.jacc.2019.04.019","article-title":"Cognitive decline before and after incident coronary events","volume":"73","author":"Xie","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"e2234208","DOI":"10.1001\/jamanetworkopen.2022.34208","article-title":"Association of cystatin C kidney function measures with long-term deficit-accumulation frailty trajectories and physical function decline","volume":"5","author":"Li","year":"2022","journal-title":"JAMA Netw Open"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1002\/jcsm.13541","article-title":"Bidirectional transitions of sarcopenia states in older adults: the longitudinal evidence from CHARLS","volume":"15","author":"Luo","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1186\/s10020-024-00817-8","article-title":"Glucagon-like peptide-1 receptor agonist exendin 4 ameliorates diabetes-associated vascular calcification by regulating mitophagy through the AMPK signaling pathway","volume":"30","author":"Chen","year":"2024","journal-title":"Mol Med"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"103223","DOI":"10.1016\/j.arcmed.2025.103223","article-title":"Impact of endurance exercise and Nano-selenium on mitochondrial gene expression in skeletal muscle of smoke-exposed rats with COPD","volume":"56","author":"Bakhshi","year":"2025","journal-title":"Arch Med Res"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.14336\/ad.2025.0419","article-title":"Exercise as a metabolic regulator: targeting AMPK\/mTOR-autophagy crosstalk to counteract sarcopenic obesity","author":"Zhang","year":"2025","journal-title":"Aging Dis"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"155743","DOI":"10.1016\/j.phymed.2024.155743","article-title":"Phlorizin from Lithocarpus litseifolius [Hance] Chun ameliorates FFA-induced insulin resistance by regulating AMPK\/PI3K\/AKT signaling pathway","volume":"130","author":"Zhao","year":"2024","journal-title":"Phytomedicine"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"970","DOI":"10.3390\/cells9091970","article-title":"Mechanisms of IGF-1-mediated regulation of skeletal muscle hypertrophy and atrophy","volume":"9","author":"Yoshida","year":"2020","journal-title":"Cells"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"525","DOI":"10.1016\/j.neubiorev.2019.09.040","article-title":"Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity","volume":"107","author":"Kandola","year":"2019","journal-title":"Neurosci Biobehav Rev"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1021\/acsestwater.1c00366","article-title":"Communicating water, sanitation, and hygiene under sustainable development goals 3, 4, and 6 as the panacea for epidemics and pandemics referencing the succession of COVID-19 surges","volume":"2","author":"Matta","year":"2022","journal-title":"ACS ES T Water"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.1186\/s12889-024-18889-w","article-title":"The effects of cognitive leisure activities on frailty transitions in older adults in China: a CHARLS-based longitudinal study","volume":"24","author":"Sheng","year":"2024","journal-title":"BMC Public Health"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1058","DOI":"10.1093\/eurheartj\/ehad885","article-title":"Changes in frailty and incident cardiovascular disease in three prospective cohorts","volume":"45","author":"He","year":"2024","journal-title":"Eur Heart J"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"632","DOI":"10.1002\/jcsm.13169","article-title":"Associations of metabolic heterogeneity of obesity with frailty progression: results from two prospective cohorts","volume":"14","author":"He","year":"2023","journal-title":"J Cachexia Sarcopenia Muscle"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1551282\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T12:41:34Z","timestamp":1778676094000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1551282\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,5]]},"references-count":36,"alternative-id":["10.3389\/fpubh.2025.1551282"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1551282","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,5]]},"article-number":"1551282"}}