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Objective <p>To compare body composition and functional indicators between prefrail and frail older adults and to identify factors independently associated with frailty status.</p> Methods <p>In this cross-sectional study 2088 community-dwelling adults aged ≥ 65&#xa0;years who met prefrail or frail criteria were identified using the FRAIL screening scale. Body composition was measured by bioelectrical impedance analysis, and handgrip strength and calf circumference were assessed. Multivariable logistic regression and a&#xa0;random forest model (to corroborate variable importance rankings) were used for statistical analyses.</p> Results <p>Muscle-related indicators were lower in frail participants (all <i>P</i> &lt; 0.001); fat-related indicators did not differ. Lower appendicular skeletal muscle mass index (ASMI) was independently associated with frailty (odds ratio, OR = 0.89, 95% confidence interval, CI 0.80–0.99). Total body protein showed a&#xa0;strong association in the body composition model (OR = 0.45, 95% CI 0.21–0.96). In the clinically practical model, handgrip strength was significantly associated with frailty status (OR = 0.96, 95% CI 0.94–0.98) and remained associated with frailty in mechanistic models (OR = 0.98, 95% CI 0.97–0.99).</p> Conclusion <p>In this cross-sectional comparison, muscle function showed a&#xa0;stronger independent association with frailty status than muscle mass alone. Frailty was associated with lower protein and mineral content, findings that require confirmation with more precise measurement methods. Handgrip strength is an efficient, low-cost indicator that was strongly associated with frailty and should be prioritized for community screening.</p>

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Cross-sectional associations of handgrip strength and appendicular skeletal muscle mass index with frailty status in prefrail and frail older adults

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Wei Li,
  • Qi Xiang,
  • Xiaodan Xue,
  • Dandan Li,
  • Yi Pan,
  • Wenlong Zheng,
  • Mingyue Zhang

摘要

Objective

To compare body composition and functional indicators between prefrail and frail older adults and to identify factors independently associated with frailty status.

Methods

In this cross-sectional study 2088 community-dwelling adults aged ≥ 65 years who met prefrail or frail criteria were identified using the FRAIL screening scale. Body composition was measured by bioelectrical impedance analysis, and handgrip strength and calf circumference were assessed. Multivariable logistic regression and a random forest model (to corroborate variable importance rankings) were used for statistical analyses.

Results

Muscle-related indicators were lower in frail participants (all P < 0.001); fat-related indicators did not differ. Lower appendicular skeletal muscle mass index (ASMI) was independently associated with frailty (odds ratio, OR = 0.89, 95% confidence interval, CI 0.80–0.99). Total body protein showed a strong association in the body composition model (OR = 0.45, 95% CI 0.21–0.96). In the clinically practical model, handgrip strength was significantly associated with frailty status (OR = 0.96, 95% CI 0.94–0.98) and remained associated with frailty in mechanistic models (OR = 0.98, 95% CI 0.97–0.99).

Conclusion

In this cross-sectional comparison, muscle function showed a stronger independent association with frailty status than muscle mass alone. Frailty was associated with lower protein and mineral content, findings that require confirmation with more precise measurement methods. Handgrip strength is an efficient, low-cost indicator that was strongly associated with frailty and should be prioritized for community screening.