Related Experiment Video
Updated: Jul 23, 2026
Frailty Assessment in an Aging Mouse Model
Published on: September 23, 2025
Frailty Index and Risk of Ischemic Stroke in China: Evidence from a Cohort Study, Disease Burden Analysis, and
Yanlong Zhou1, Dongdong Jia1,2, Zengcai Liu1
1National Pharmaceutical Engineering Center for Solid Preparation of Chinese Herbal Medicine, Jiangxi University of Chinese Medicine, Nanchang 330006, China.
Insights
Frailty index (FI) is linked to higher stroke risk in Chinese adults. Genetic analysis confirms frailty
Area of Science:
- Gerontology
- Neurology
- Epidemiology
Background:
- Stroke poses a significant health burden in China.
- The frailty index (FI) is a measure of cumulative health deficits.
- Understanding factors contributing to stroke risk is crucial for public health.
Purpose of the Study:
- To investigate the association between the frailty index (FI) and stroke risk in Chinese adults.
- To describe stroke burden trends in China.
- To explore the potential causal role of FI in ischemic stroke using Mendelian randomization.
Main Methods:
- Utilized data from the China Health and Retirement Longitudinal Study (CHARLS) with 13,473 participants.
- Employed Cox models and restricted cubic splines to assess modified frailty index (mFI) and stroke risk.
- Conducted two-sample Mendelian randomization to evaluate causal effects of FI on ischemic stroke subtypes, using Global Burden of Disease (GBD) 2021 data for stroke trends.
Main Results:
- Each 0.1-point increase in mFI correlated with a 16% rise in stroke risk (HR=1.16).
- A linear dose-response relationship was observed between mFI and incident stroke.
- Mendelian randomization provided genetic evidence for a causal link between FI and ischemic stroke, particularly large-artery atherosclerotic and small-vessel stroke.
Conclusions:
- Elevated frailty index (FI) is significantly associated with increased stroke risk in Chinese adults.
- Genetic evidence supports a causal role of FI in ischemic stroke.
- FI may enhance current stroke risk assessment strategies.
Abstract:
Objective: This study aims to examine the association between the frailty index (FI) and stroke risk among Chinese adults, describe the burden of stroke in China, and explore the causal role of FI in ischemic stroke through Mendelian randomization. Methods: Data from the China Health and Retirement Longitudinal Study (CHARLS) included 13,473 participants aged 45 years and older without a history of stroke. Cox models, restricted cubic splines, and sensitivity analyses were employed to assess the association between the modified frailty index (mFI) and incident stroke. Additionally, data from the Global Burden of Disease (GBD) 2021 data report were utilized to describe stroke trends in China from 1990 to 2021. Two-sample Mendelian randomization was conducted to evaluate the causal effects of FI on ischemic stroke subtypes. Results: During a median follow-up period of approximately 7 years, 811 incident strokes were recorded. Each 0.1-point increase in mFI was associated with a 16% increase in stroke risk (HR = 1.16, 95% CI: 1.06-1.27), demonstrating a linear dose-response relationship. From 1990 to 2021, the proportion of ischemic stroke rose from 46.9% to 63.2%. Mendelian randomization analysis provided genetic evidence supporting a causal association between FI and ischemic stroke (OR = 1.191, 95% CI: 1.046-1.357), particularly driven by large-artery atherosclerotic (OR = 1.852) and small-vessel stroke (OR = 1.415), but not by cardioembolic stroke. Conclusions: A higher FI is associated with an increased risk of stroke among Chinese adults, with genetic evidence supporting a causal role in ischemic stroke. Therefore, FI may serve as a valuable addition to existing risk assessment tools.