Dual trajectories of social participation and frailty in Chinese older adults: a longitudinal study based on CLHLS from 2008 to 2018

Introduction This study aimed to identify the dual trajectories of social participation (SP) and frailty index (FI) among Chinese older adults, and investigate common influential factors of both trajectories.Methods Utilizing data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) 2008-2018 surveys, 1,645 individuals were analyzed. A group-based dual trajectory model and logistic regression were used to examine trajectories, their interrelations and shared influencing factors.Results This study identified three SP, two FI trajectories and six distinct sub-groups of individuals. The study confirmed a long-term, interrelated relationship between two outcomes and identified some common factors. Compared to participants in the lower SP trajectory, those who followed the middle SP trajectory and higher SP trajectory had increased probabilities of belonging to the slow-growth FI trajectory (90.28 and 99.71%, respectively). And the participants in the slow-growth FI exhibited higher probabilities of belonging to the middle SP and the higher SP trajectory (37.64 and 25.34% higher, respectively) compared with those in the rapid-growth FI trajectory. Age, marital status, and drinking status were mutual factors associated with the dual trajectories.Discussion The results showed significant associations between higher levels of frailty and lower levels of social participation. Related intervention policies should consider the dual trajectories and the common factors that underlie these trajectories of SP and FI.