Frailty Related to the Exposure to Particulate Matter and Ozone: The Korean Frailty and Aging Cohort Study

This study aims to identify the association between the concentration of particulate matter <2.5 μm (PM_2.5), <10 μm (PM₁₀), and ozone (O₃) and frailty. The Korean Frailty Scale (KFS, 0-6 points) assessing physical, psychological, and social frailty, was applied to 2912 community-dwelling older adults between April 2016 and December 2017. Daily average concentrations of PM_2.5, PM₁₀, and O₃ (2015-2017) were obtained and matched with the residential areas. The frailty risk associated with exposure to PM_2.5, PM₁₀, and O₃ was evaluated using multiple logistic regression after adjusting for age, sex, BMI, lifestyle, socioeconomic status, and comorbidity. Participants were categorized into robust (0 points, 28.7%), pre-frail (1-2 points, 50.1%), and frail (≥3 points, 21.2%) groups. Each 1 μg/m³ increase of PM_2.5 and PM₁₀ increased the odds ratios (ORs) and 95% confidence intervals (CIs) of the frail group compared to the robust group: 1.055 (1.002, 1.112) and 1.095 (1.060, 1.131), and the pre-frail group: 1.053 (1.017, 1.090) and 1.062 (1.037, 1.087), respectively. Each 1-ppb increase of O₃ increased the OR (95% CI) of the frail group: 1.041 (1.023, 1.059) and the pre-frail group: 1.005 (0.985, 1.025). PM_2.5, PM₁₀, and O₃ may be associated dose-dependently with the frailty.