Impact of Health Promotion Behaviors on Frailty Among Older Adults in China

### Impact of Health Promotion Behaviors on Frailty Among Older Adults in China

**Abstract**: Frailty is increasingly recognized as a significant health concern among older adults, especially in regions experiencing rapid demographic changes, such as China. A recent study published in *BMC Geriatrics* investigates the relationship between health promotion behaviors and frailty among Chinese adults aged 60 and above. This article examines the findings of this research, highlighting the implications for public health and policy.

**Introduction**: Frailty, characterized as a state of decreased physiological reserve and increased vulnerability to stressors, poses a challenge to healthy aging. It is associated with adverse health outcomes, including increased risk of falls, hospitalization, and mortality. As such, addressing frailty through modifiable factors, particularly health promotion behaviors, is crucial for enhancing the quality of life among older adults. According to the World Health Organization (WHO), promoting healthy lifestyles is essential for improving health outcomes in aging populations.

**Research Overview**: The study utilized data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) conducted in 2018, which included 10,388 participants aged 60 years and older. Researchers assessed health promotion behaviors across six dimensions: health responsibility, nutrition, physical activity, stress management, interpersonal support, and self-actualization, following Pender’s health promotion model. The findings revealed that 42.8% of participants were categorized as robust, 34.9% as pre-frail, and 22.3% as frail. Notably, frail individuals exhibited lower levels of health promotion behaviors and greater socioeconomic disadvantages compared to their robust counterparts.

**Key Findings**: The study found significant associations between specific health promotion behaviors and frailty states. Better nutritional behaviors and higher levels of physical activity were linked to lower odds of frailty and pre-frailty. Conversely, increased stress management and interpersonal support correlated with higher frailty risks. The results indicate that frailty is not only a consequence of aging but also a condition that can be influenced by lifestyle choices.

**Gender and Age Differences**: The analysis uncovered notable gender differences in health promotion behaviors. Women, who constituted a larger proportion of frail individuals, were more likely to experience socioeconomic disadvantages and report poorer health outcomes. Moreover, older adults aged 79 and above demonstrated different health promotion behavior patterns compared to those aged 60-79, suggesting that targeted interventions may be necessary for these distinct age groups.

**Implications for Public Health**: The findings underscore the importance of promoting multidimensional health behaviors as a strategy to combat frailty among older adults. Interventions focusing on nutrition and physical activity may be particularly effective in reducing frailty risks. Public health initiatives should aim to raise awareness of the preventable nature of frailty and encourage older adults to adopt healthier lifestyles.

**Conclusion**: This research contributes to the understanding of frailty among older adults in China, suggesting that health promotion behaviors play a critical role in mitigating frailty risks. Future studies should explore the causal relationships between these behaviors and frailty, as well as the effectiveness of targeted interventions in diverse aging populations.

**References**: 1. Chen, Y., Chen, X., Zhao, Y., et al. (2025). Association of health promotion behaviors with frailty in Chinese middle-aged and older adults: a cross-sectional study. *BMC Geriatrics*, 25, 553. 2. World Health Organization. (2015). *World report on ageing and health*. 3. Pender, N. J. (1990). Health promotion model: a theory for health promotion in the workplace. 4. Ensrud, K. E., & Kats, A. M. (2018). Frailty phenotype and healthcare costs and utilization in older men. *J Am Geriatr Soc*, 68(9), 2034-2042. 5. Rockwood, K., & Mitnitski, A. (2007). Frailty in relation to the accumulation of deficits. *J Gerontol A Biol Sci Med Sci*, 62(7), 722-727.

This comprehensive analysis of the connection between health promotion behaviors and frailty provides valuable insights for healthcare professionals and policymakers focused on improving the health and quality of life of older adults in China.