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Clinical Summary

Frailty Tied to Irritable Bowel Syndrome Risk in Middle-aged and Older Adults


  • Frailty and pre-frailty were significantly associated with a higher risk of incident irritable bowel syndrome in middle-aged and older adults.

Why This Matters

  • Interventions aimed at improving the frailty of middle-aged and older adults may be a promising targeted strategy for the detection, diagnosis, and treatment of irritable bowel syndrome.

Study Design

  • An ongoing prospective cohort study of 176,423 participants (age 37-73 years) without irritable bowel syndrome, coeliac disease, inflammatory bowel disease, and any cancer, identified from the UK Biobank (2006-2010).
  • Funding: National Natural Science Foundation of China and National Key Research and Development Program of China.

Key Results

  • Overall, 7994 (4.5%) and 78,957 (44.8%) participants were frail and pre-frail at baseline, respectively.
  • During a median follow-up of 13.2 years, 4155 cases of incident irritable bowel syndrome were reported.
  • Compared with participants without frailty, the risk of developing irritable bowel syndrome was significantly higher in those with (adjusted HR [aHR]; 95% CI):
    • frailty (1.80; 1.59 to 2.04); and
    • pre-frailty (1.21; 1.14 to 1.30; P<0.001 for all).
  • The risk of irritable bowel syndrome was significantly higher in (aHR; 95% CI):
    • older adults with:
      • frailty (1.69; 1.37 to 2.08); and
      • pre-frailty (1.24; 1.12 to 1.39; P<0.001 for all).
    • middle-aged adults with:
      • frailty (1.90; 1.62 to 2.22); and
      • pre-frailty (1.19; 1.10 to 1.30; P<0.001 for all).
  • Sensitivity and subgroup analysis showed similar results.


  • Frailty phenotype was evaluated using the adapted Fried criteria, based on a mix of self-reported and objective measurements.
  • Risk of residual confounding.