Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study

Abstract To investigate the prospective association of frailty status, especially the early stage, with the long-term risk of Gastroesophageal reflux disease (GERD) in a large prospective cohort. We included participants who were free of GERD and cancer at baseline and use of aspirin and non-steroid...

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Main Authors: Lei Peng, Xueqin Li, Jinfeng Qi, Yangang Shan, Liming Zhang, Zhenqing Yang, Xucheng Wu, George O. Agogo, Zuyun Liu, Genxiang Mao, Honglei Wu
Format: Article
Language:English
Published: Nature Portfolio 2025-03-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-93114-1
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author Lei Peng
Xueqin Li
Jinfeng Qi
Yangang Shan
Liming Zhang
Zhenqing Yang
Xucheng Wu
George O. Agogo
Zuyun Liu
Genxiang Mao
Honglei Wu
author_facet Lei Peng
Xueqin Li
Jinfeng Qi
Yangang Shan
Liming Zhang
Zhenqing Yang
Xucheng Wu
George O. Agogo
Zuyun Liu
Genxiang Mao
Honglei Wu
author_sort Lei Peng
collection DOAJ
description Abstract To investigate the prospective association of frailty status, especially the early stage, with the long-term risk of Gastroesophageal reflux disease (GERD) in a large prospective cohort. We included participants who were free of GERD and cancer at baseline and use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) from the UK Biobank (UKB). Frailty status was assessed using Fried phenotype including five items (weight loss, exhaustion, low grip strength, low physical activity, slow walking pace) and classified as non-frail, pre-frail, and frail. The outcome was incident GERD. The frailty status was assessed using Cox proportional hazard model. Among 327,965 participants (mean age 56.6 years) at baseline, 151,689 (46.3%) were pre-frail and 14,288 (4.4%) were frail. During a median of 13.5-years of follow-up, 31,027 (9.5%) participants developed GERD. Compared with non-frail participants, pre-frail (hazard ratios [HR] = 1.21, 95% confidence interval [CI] 1.18–1.24) and frail (HR = 1.60, 95% CI 1.52–1.68) participants had significantly higher risks of GERD. Among the five indicators of frailty, exhaustion demonstrated the strongest association with the risk of GERD (HR = 1.42, 95% CI 1.38–1.47). Subgroup analysis showed strong associations among younger (< 60 years), female, high-educated, unemployed participants, and those who had BMI < 18.5 kg/m2 (all P for interaction < 0.05). Frailty, especially pre-frail, which is potentially reversible, was associated with higher risk of GERD in middle-aged and older individuals. The findings underscore the importance of integrating routine frailty assessments and interventions, especially at the early stage, to improve digestive health.
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spelling doaj-art-fdb281bd60ac4b6f8ff6eb3080eaa59f2025-08-20T02:56:09ZengNature PortfolioScientific Reports2045-23222025-03-011511910.1038/s41598-025-93114-1Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort studyLei Peng0Xueqin Li1Jinfeng Qi2Yangang Shan3Liming Zhang4Zhenqing Yang5Xucheng Wu6George O. Agogo7Zuyun Liu8Genxiang Mao9Honglei Wu10Department of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong UniversityCenter for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineDepartment of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong UniversityDepartment of Outpatient, Shanxian Center HospitalCenter for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineCenter for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineCenter for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineStatsDecide Analytics and Consulting LtdCenter for Clinical Big Data and Analytics of the Second Affiliated Hospital, and Department of Big Data in Health Science School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of MedicineZhejiang Key Laboratory of Geriatrics and Geriatrics Institute of Zhejiang Province, Zhejiang HospitalDepartment of Gastroenterology, The Second Hospital, Cheeloo College of Medicine, Shandong UniversityAbstract To investigate the prospective association of frailty status, especially the early stage, with the long-term risk of Gastroesophageal reflux disease (GERD) in a large prospective cohort. We included participants who were free of GERD and cancer at baseline and use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) from the UK Biobank (UKB). Frailty status was assessed using Fried phenotype including five items (weight loss, exhaustion, low grip strength, low physical activity, slow walking pace) and classified as non-frail, pre-frail, and frail. The outcome was incident GERD. The frailty status was assessed using Cox proportional hazard model. Among 327,965 participants (mean age 56.6 years) at baseline, 151,689 (46.3%) were pre-frail and 14,288 (4.4%) were frail. During a median of 13.5-years of follow-up, 31,027 (9.5%) participants developed GERD. Compared with non-frail participants, pre-frail (hazard ratios [HR] = 1.21, 95% confidence interval [CI] 1.18–1.24) and frail (HR = 1.60, 95% CI 1.52–1.68) participants had significantly higher risks of GERD. Among the five indicators of frailty, exhaustion demonstrated the strongest association with the risk of GERD (HR = 1.42, 95% CI 1.38–1.47). Subgroup analysis showed strong associations among younger (< 60 years), female, high-educated, unemployed participants, and those who had BMI < 18.5 kg/m2 (all P for interaction < 0.05). Frailty, especially pre-frail, which is potentially reversible, was associated with higher risk of GERD in middle-aged and older individuals. The findings underscore the importance of integrating routine frailty assessments and interventions, especially at the early stage, to improve digestive health.https://doi.org/10.1038/s41598-025-93114-1FrailtyGastroesophageal reflux diseaseCohort studyAging
spellingShingle Lei Peng
Xueqin Li
Jinfeng Qi
Yangang Shan
Liming Zhang
Zhenqing Yang
Xucheng Wu
George O. Agogo
Zuyun Liu
Genxiang Mao
Honglei Wu
Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study
Scientific Reports
Frailty
Gastroesophageal reflux disease
Cohort study
Aging
title Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study
title_full Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study
title_fullStr Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study
title_full_unstemmed Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study
title_short Pre-frailty is associated with higher risk of gastroesophageal reflux disease: a large prospective cohort study
title_sort pre frailty is associated with higher risk of gastroesophageal reflux disease a large prospective cohort study
topic Frailty
Gastroesophageal reflux disease
Cohort study
Aging
url https://doi.org/10.1038/s41598-025-93114-1
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