{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:07:54Z","timestamp":1788847674536,"version":"build-2803163510"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"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>Background<\/jats:title>\n                    <jats:p>Frailty is a major public health challenge among older adults. Indigenous populations experience poorer health outcomes and a greater burden of frailty than the general population. However, evidence on modifiable factors associated with frailty in Taiwanese Indigenous older adults remains limited. This study examined the associations between nutritional status, anthropometric characteristics, physical function, physical activity, and frailty among Indigenous older adults living in rural communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A community-based, cross-sectional study was conducted among 117 Indigenous older adults aged \u226555\u202fyears attending Indigenous Cultural Health Stations. As the outcome measure, frailty was assessed using the Chinese version of the Clinical Frailty Scale (CFS-C). Predictor variables included nutritional status measured using the Mini Nutritional Assessment\u2013Short Form, anthropometric characteristics (body mass index and calf circumference), physical function (handgrip strength and preferred gait speed), and physical activity assessed using the International Physical Activity Questionnaire\u2013Short Form. Multivariable binary logistic regression was performed to identify factors independently associated with frailty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 117 participants, 27 (23.1%) were classified as frail (CFS-C\u202f\u2265\u202f4). Compared with non-frail participants, frail participants were older and had slower preferred gait speed, weaker handgrip strength, and lower physical activity levels (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.01). After adjustment for age, sex, handgrip strength, preferred gait speed, and physical activity, faster preferred gait speed (OR\u202f=\u202f0.266, 95% CI\u202f=\u202f0.139\u20130.510,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;\u202f0.001) and higher physical activity (OR\u202f=\u202f0.998, 95% CI\u202f=\u202f0.996\u20130.999,\n                      <jats:italic>p<\/jats:italic>\n                      =\u202f0.007) remained independently associated with lower odds of frailty.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preferred gait speed and physical activity were independently associated with lower odds of frailty among Indigenous older adults. Routine gait speed assessment and attention to physical activity in Indigenous Cultural Health Stations may support frailty identification and community-based health promotion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1941122","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:36:09Z","timestamp":1788845769000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Modifiable factors associated with frailty among indigenous older adults in southern Taiwan: a community-based cross-sectional study"],"prefix":"10.3389","volume":"14","author":[{"given":"Aih-Fung","family":"Chiu","sequence":"first","affiliation":[{"name":"Department of Nursing, Cheng Shiu University","place":["Kaohsiung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Fung","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Nursing, Kaohsiung Veterans General Hospital","place":["Kaohsiung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Man","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Nursing, Tajen University","place":["Yanpu, Pingtung, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1093\/ageing\/afaa219","article-title":"Prevalence of frailty in 62 countries across the world: a systematic review and meta-analysis of population-level studies","volume":"50","author":"O'Caoimh","year":"2021","journal-title":"Age Ageing"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1152\/physrev.00037.2021","article-title":"Multisystem physiological perspective of human frailty and its modulation by physical activity","volume":"103","author":"Taylor","year":"2023","journal-title":"Physiol Rev"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"116264","DOI":"10.1016\/j.isci.2026.116264","article-title":"Frailty syndrome in older adults: research advances and management strategies","volume":"29","author":"Guo","year":"2026","journal-title":"iScience"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"Itc17","DOI":"10.7326\/ANNALS-25-04412","article-title":"Frailty","volume":"179","author":"Orkaby","year":"2026","journal-title":"Ann Intern Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1111\/j.1532-5415.2012.04054.x","article-title":"Prevalence of frailty in community-dwelling older persons: a systematic review","volume":"60","author":"Collard","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"S43","DOI":"10.1016\/S0167-4943(10)70012-1","article-title":"The prevalence of subjective frailty and factors associated with frailty in Taiwan","volume":"50","author":"Chen","year":"2010","journal-title":"Arch Gerontol Geriatr"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/S0929-6646(11)60037-5","article-title":"Prevalence and correlates of geriatric frailty in a northern Taiwan community","volume":"110","author":"Chang","year":"2011","journal-title":"J Formos Med Assoc"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"785460","DOI":"10.3389\/fpubh.2021.785460","article-title":"Frailty in indigenous populations: a scoping review","volume":"9","author":"Lewis","year":"2021","journal-title":"Front Public Health"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.maturitas.2020.05.010","article-title":"Global frailty: the role of ethnicity, migration and socioeconomic factors","volume":"139","author":"Majid","year":"2020","journal-title":"Maturitas"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/s12546-024-09332-3","article-title":"A scoping review of determinants of indigenous health and health disparities in Taiwan: present evidence and paradigms","volume":"41","author":"Chen","year":"2024","journal-title":"J Popul Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"659","DOI":"10.1093\/gerona\/gly110","article-title":"Frailty and multimorbidity: a systematic review and meta-analysis","volume":"74","author":"Vetrano","year":"2019","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"e0283596","DOI":"10.1371\/journal.pone.0283596","article-title":"Malnutrition as a major related factor of frailty among older adults residing in long-term care facilities in Korea","volume":"18","author":"Moon","year":"2023","journal-title":"PLoS One"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1016\/j.jamda.2020.03.006","article-title":"Frailty, sarcopenia, and malnutrition frequently (co-)occur in hospitalized older adults: a systematic review and meta-analysis","volume":"21","author":"Ligthart-Melis","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1093\/ageing\/afab039","article-title":"Abdominal obesity, body mass index and the risk of frailty in community-dwelling older adults: a systematic review and meta-analysis","volume":"50","author":"Yuan","year":"2021","journal-title":"Age Ageing"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1016\/j.clnu.2013.07.013","article-title":"Calf circumference, frailty and physical performance among older adults living in the community","volume":"33","author":"Landi","year":"2014","journal-title":"Clin Nutr"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"M146","DOI":"10.1093\/gerona\/56.3.m146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2164","DOI":"10.1038\/s43587-025-01004-y","article-title":"A focus shift from sarcopenia to muscle health in the Asian working group for sarcopenia 2025 consensus update","volume":"5","author":"Chen","year":"2025","journal-title":"Nat Aging"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"1826097","DOI":"10.3389\/fpubh.2026.1826097","article-title":"Association between physical activity level and frailty status among community-dwelling older adults with multimorbidity: a cross-sectional study","volume":"14","author":"Wang","year":"2026","journal-title":"Front Public Health"},{"key":"ref19","year":"2025"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"e0170878","DOI":"10.1371\/journal.pone.0170878","article-title":"Physical activity and trajectories of frailty among older adults: evidence from the English longitudinal study of ageing","volume":"12","author":"Rogers","year":"2017","journal-title":"PLoS One"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"604","DOI":"10.1186\/s12877-022-03287-x","article-title":"Validation of clinical frailty scale in Chinese translation","volume":"22","author":"Chou","year":"2022","journal-title":"BMC Geriatr"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"M366","DOI":"10.1093\/gerona\/56.6.m366","article-title":"Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF)","volume":"56","author":"Rubenstein","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1007\/s12603-009-0214-7","article-title":"Validation of the mini nutritional assessment short-form (MNA-SF): a practical tool for identification of nutritional status","volume":"13","author":"Kaiser","year":"2009","journal-title":"J Nutr Health Aging"},{"key":"ref24","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":"ref25","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1093\/ageing\/afr051","article-title":"A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach","volume":"40","author":"Roberts","year":"2011","journal-title":"Age Ageing"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1093\/gerona\/gly148","article-title":"Consensus on shared measures of mobility and cognition: from the Canadian consortium on neurodegeneration in aging (CCNA)","volume":"74","author":"Montero-Odasso","year":"2019","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1097\/01.jnr.0000387313.20386.0a","article-title":"Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ","volume":"16","author":"Liou","year":"2008","journal-title":"J Nurs Res"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International physical activity questionnaire: 12-country reliability and validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med Sci Sports Exerc"},{"key":"ref29","author":"Sjostrom","year":"2005"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1001\/jama.2010.1923","article-title":"Gait speed and survival in older adults","volume":"305","author":"Studenski","year":"2011","journal-title":"JAMA"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1002\/jcsm.12667","article-title":"How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review","volume":"12","author":"Bortone","year":"2021","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e0278226","DOI":"10.1371\/journal.pone.0278226","article-title":"Effect of physical activity on the risk of frailty: a systematic review and meta-analysis","volume":"17","author":"Zhao","year":"2022","journal-title":"PLoS One"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"130","DOI":"10.6890\/IJGE.202507_19(3).0001","article-title":"Physical activity in the prevention and treatment of frailty among older adults: potential mechanism and clinical evidence - a narrative review","volume":"19","author":"Chou","year":"2025","journal-title":"Int J Gerontol"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.mad.2019.03.004","article-title":"The impact of physical activity and sedentary behaviors on frailty levels","volume":"180","author":"Kehler","year":"2019","journal-title":"Mech Ageing Dev"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1177\/10105395251400128","article-title":"Listening to indigenous elders: an evaluation of the cultural health stations in Taiwan","volume":"38","author":"Huang","year":"2026","journal-title":"Asia Pac J Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.ijcard.2016.04.068","article-title":"Objective measures of the frailty syndrome (hand grip strength and gait speed) and cardiovascular mortality: a systematic review","volume":"215","author":"Chainani","year":"2016","journal-title":"Int J Cardiol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1186\/s12877-017-0496-2","article-title":"Nutritional determinants of frailty in older adults: a systematic review","volume":"17","author":"Lorenzo-L\u00f3pez","year":"2017","journal-title":"BMC Geriatr"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1007\/s11357-020-00163-7","article-title":"Sex-specific muscle and metabolic biomarkers associated with gait speed and cognitive transitions in older adults: a 9-year follow-up","volume":"42","author":"Waters","year":"2020","journal-title":"Geroscience"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.maturitas.2014.11.010","article-title":"The association between sedentary behaviour, moderate-vigorous physical activity and frailty in NHANES cohorts","volume":"80","author":"Blodgett","year":"2015","journal-title":"Maturitas"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1941122\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:36:10Z","timestamp":1788845770000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2026.1941122\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":39,"alternative-id":["10.3389\/fpubh.2026.1941122"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2026.1941122","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]},"article-number":"1941122"}}