Dynamic changes in physical frailty and associated factors among community-dwelling older adults in Chiang Mai: a prospective cohort study

Silent and dynamic physical frailty causes rapid functional decline and dependency. This study aimed to determine risk factors for physical frailty progression or improvement. A prospective cohort study was conducted in Chiang Mai, Thailand, involving community residents aged 65 to 84. Participants were recruited in 2021 and were followed between May 2023 and September 2023. Physical frailty was assessed using modified Fried’s criteria. A generalized linear model was used to examine factors associated with frailty transitions. Among 251 participants, 76 were classified as frail and 175 as robust/pre-frail at follow-up. Transition to frailty was significantly associated with living alone (aRR 2.25 [1.03–4.93]), being at risk of malnutrition (aRR 7.73 [1.81–32.96]), lower calf circumference (aRR 0.81 [0.69–0.92]), higher triceps skinfold thickness (aRR 1.09 [1.01–1.17]), and a history of stroke (aRR 3.31 [1.03–10.59]). In the frailty subgroup, increased TUGT time (aRR 0.87 [0.79–0.95]), low physical activity (aRR 0.63 [0.43–0.92]), slow walking speed (aRR 0.90 [0.81–0.99]), and weak handgrip strength (aRR 0.62 [0.41–0.94]) were associated with a decreased likelihood of transitioning to a robust/pre-frail state. Physical frailty is a reversible and dynamic condition. The study findings could help community healthcare teams identify community-dwelling older adults at-risk who require additional assessments and interventions.