Evidence map›Paper›PMID 42557523›Full record

ArticleGeroScience2026

Frailty before chronic disease: multisystem physiological differences in middle-aged adults from the UK Biobank.

Paula Stürmer, Gabriella C Silva, Aurore Fayosse, Romain Pichon, Séverine Sabia, Wolfgang Lieb, Benjamin Landré

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In one paragraph

Article in GeroScience, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Paula StürmerInstitute of Epidemiology, Kiel University, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany. paula.stuermer@epi.uni-kiel.de.ORCID http://orcid.org/0009-0008-3305-5629
Gabriella C SilvaCentre for Research in Epidemiology and Statistics (CRESS), Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité and Université Sorbonne Paris Nord, Inserm U1153, INRAE, Paris, France.
Aurore FayosseCentre for Research in Epidemiology and Statistics (CRESS), Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité and Université Sorbonne Paris Nord, Inserm U1153, INRAE, Paris, France.
Romain PichonDepartment of Research, Institut de Formation en Pédicurie-Podologie, Ergothérapie Et Masso-Kinésithérapie (IFPEK), Rennes, France.
Séverine SabiaCentre for Research in Epidemiology and Statistics (CRESS), Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité and Université Sorbonne Paris Nord, Inserm U1153, INRAE, Paris, France.
Wolfgang LiebInstitute of Epidemiology, Kiel University, University Hospital Schleswig-Holstein Campus Kiel, Kiel, Germany.
Benjamin LandréCentre for Research in Epidemiology and Statistics (CRESS), Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité and Université Sorbonne Paris Nord, Inserm U1153, INRAE, Paris, France.

Funding

European Union 101043884France 2030 ANR-23-PAVH-0006Institute pour la Recherche en Santé Publique AAP-2023-APAOB-318115
6 · The paper itself

Abstract

Frailty, defined as increased vulnerability to stressors and impaired recovery of homeostasis, poses a major health challenge among older and multimorbid adults. Frailty is also observed in middle-aged and disease-free adults, though evidence remains scarce. Understanding the physiological characteristics of frail individuals free of chronic diseases may inform about the underlying mechanisms of frailty and its clinical management. We assessed frailty in a large disease-free middle-aged cohort and examined the associations of markers of physiological function with frailty. We analyzed data from 117,163 middle-aged adults (mean age 53.9 ± 8.0 years) free of known chronic conditions from the UK Biobank. Associations between frailty status (robust, prefrail, frail; defined using the Fried Frailty Phenotype) and 29 physiological markers were examined using multinomial logistic regression adjusted for sociodemographic and lifestyle factors. Overall, 1,293 (1.1%) participants were frail and 38,401 (32.8%) prefrail. Anthropometric measures (body fat % waist-to-hip ratio), triglycerides, some markers of hepatic (gamma-glutamyl transferase, alkaline phosphatase) and renal function (cystatin C), glucose metabolism (HbA1c), inflammation (hsCRP), and white blood cell count including leukocyte and neutrophil count and the neutrophil-to-lymphocyte ratio were directly associated with frailty. In contrast, blood pressure, lung function markers (FEV1, FVC), other hepatic (aspartate aminotransferase, bilirubin) and renal markers (creatinine and creatinine-to-cystatin C ratio), and the endocrine marker IGF-1 were inversely associated with frailty. Associations were generally similar but weaker for prefrailty. Frailty in disease-free middle-aged adults was associated with multisystem physiological alterations resembling those observed in older and multimorbid populations, suggesting early physiological dysregulation preceding clinically manifest chronic disease.

Indexed as

Chronic diseaseFrailtyMarkers of physiological functionMiddle-aged populationUK Biobank

Identifiers

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.