The association of particulate matter 2.5 exposure with frailty trajectories in middle-aged and older Chinese adults and the potential modification by lifestyle and socioeconomic status
Wanting Lin, Haoxiang Lang, Zhousong Luo, Zirong YeObjective:
To examine PM2.5 exposure associations with frailty trajectories in middle-aged and older Chinese adults, and evaluate modifying effects of lifestyle and socioeconomic status (SES).
Methods:
We analyzed 10,659 participants from CHARLS using PM2.5 data from Dalhousie University. Frailty was assessed via a deficit accumulation index. Group-based trajectory modelling (GBTM) identified frailty trajectories; ordered logistic regression estimated associations and effect modifications.
Results:
Three trajectories emerged: "Stable low" (63.95%), "Increased to frailty" (29.00%), and "Continuously worsening" (7.05%). Each 10 μg/m³ PM2.5 increase raised odds of Trajectories 2 and 3 by 15.2% and 12.3%, respectively. Higher SES attenuated PM2.5 effects (RERI=−0.067), while unhealthy sleep duration amplified them (RERI=0.163).
Conclusions:
PM2.5 exposure is associated with deteriorating frailty trajectories. Higher SES exerts an antagonistic effect, whereas unhealthy sleep duration has a synergistic effect on PM2.5-related frailty progression.