Association between Solid Cooking Fuel Use and Frailty Trajectories: Findings from a Nationwide Cohort in China.

Yang LIU; Bing Jie WU; Bing Bing FAN; Chun Xia LI; Chang SU; Ai Dong LIU; Tao ZHANG

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Association between Solid Cooking Fuel Use and Frailty Trajectories: Findings from a Nationwide Cohort in China.

Author: Yang LIU ¹ ; Bing Jie WU ¹ ; Bing Bing FAN ¹ ; Chun Xia LI ¹ ; Chang SU ² ; Ai Dong LIU ² ; Tao ZHANG ¹
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1. Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;Institute for Medical Dataology, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China.
2. National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Publication Type:Journal Article
Keywords: Ageing; Frailty; Longitudinal studies; Solid fuel
MeSH: Humans; China/epidemiology*; Cooking; Male; Female; Middle Aged; Aged; Air Pollution, Indoor/adverse effects*; Frailty/etiology*; Longitudinal Studies; Cohort Studies
From: Biomedical and Environmental Sciences 2025;38(6):653-665
CountryChina
Language:English
Abstract: OBJECTIVE:Burning solid cooking fuel contributes to household air pollution and is associated with frailty. However, how solid cooking fuel use contributes to the development of frailty has not been well illustrated.
METHODS:This study recruited 8,947 participants aged ≥ 45 years from the China Health and Retirement Longitudinal Study, 2011-2018. Group-based trajectory modeling was employed to identify frailty trajectories. Multinomial logistic regression was used to assess the association between solid cooking fuel use and frailty trajectories. Population-attributable fractions were used to estimate the frailty burden from solid fuel use.
RESULTS:We identified three frailty trajectories: low-stable ( n = 5,789), moderate-increasing ( n = 2,603), and fast-increasing ( n = 555). Solid fuel use was associated with higher odds of being in the moderate-increasing ( OR: 1.24, 95% CI: 1.08-1.42) and fast-increasing ( OR: 1.48, 95% CI: 1.14-1.92) trajectories. These associations were strengthened by longer solid fuel use ( P for trend < 0.001). Switching to clean fuel significantly reduced the risk of being in these trajectories compared with persistent solid fuel users. Without solid fuel, 8% of moderate- and 19% of fast-increasing trajectories demonstrated frailty development like the low-stable group.
CONCLUSION:Solid cooking fuel use is associated with frailty trajectories in middle-aged and older Chinese populations.