Frailty and frailty progression in relation to the risk of benign prostatic hyperplasia/lower urinary tract symptoms among Chinese middle-aged and older men: a prospective cohort study

Frailty and benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) are age-related conditions, but their longitudinal relationship remains unclear. This study investigated associations between frailty index (FI) trajectories, baseline frailty status, and incident BPH/LUTS in Chinese middle-aged and older men.
Data from three waves (2011–2015) of the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Group-based trajectory modeling identified FI trajectories. Multivariable logistic regression examined associations of baseline frailty status (robust, prefrail, frail) and FI trajectories with incident BPH/LUTS. Incremental predictive value of trajectories beyond baseline status was quantified using net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
Among 4,449 men, four distinct FI trajectories were identified. Compared to the Persistently Low trajectory, Moderately Increasing and High-Increasing trajectories showed significantly higher BPH/LUTS risk (ORs: 2.01 [1.38–2.99] and 2.82 [1.79–4.45]; p-trend < 0.001). Baseline prefrail and frail status were also associated with elevated risk (ORs: 1.47 [1.13–1.90] and 1.67 [1.10–2.49], respectively). Dynamic frailty trajectories demonstrated improved risk reclassification over baseline assessment alone (continuous NRI: 0.284, p < 0.001; IDI: 0.011, p = 0.001).
Both baseline frailty status and dynamic FI trajectories were independently associated with BPH/LUTS risk. Longitudinal trajectories exhibited stronger associations and greater predictive value, highlighting the importance of monitoring frailty progression for improved risk stratification and targeted prevention.

Four distinct longitudinal frailty index (FI) trajectories were identified through group-based trajectory modeling (GBTM), and their associations with incident benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) were systematically assessed in a cohort of middle-aged and older Chinese men.
Demonstrates that long-term FI trajectories, particularly progressively worsening patterns, are more strongly associated with the risk of BPH/LUTS than single time-point assessments of frailty status.
Highlights the potential of incorporating long-term monitoring of frailty progression into preventive strategies for BPH/LUTS among aging male populations.

Four distinct longitudinal frailty index (FI) trajectories were identified through group-based trajectory modeling (GBTM), and their associations with incident benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) were systematically assessed in a cohort of middle-aged and older Chinese men.
Demonstrates that long-term FI trajectories, particularly progressively worsening patterns, are more strongly associated with the risk of BPH/LUTS than single time-point assessments of frailty status.
Highlights the potential of incorporating long-term monitoring of frailty progression into preventive strategies for BPH/LUTS among aging male populations.