Association between low-density lipoprotein cholesterol and frailty in adults aged ≥70 years: a cross-sectional study from Beijing, China

Background Frailty becomes increasingly prevalent with advancing age and is influenced by multifactorial physiological and pathological processes. This study aimed to assess the current prevalence of frailty among adults aged ≥70 years and to investigate the association between low-density lipoprotein cholesterol (LDL-C) levels and frailty. Methods A cross-sectional study was conducted on 218 adults aged 70 and above in Beijing, China, collecting data on their sociodemographic characteristics, lifestyle, comorbidities, and peripheral blood biomarkers. The FRAIL scale was used to measure frailty, and the association between LDL-C and frailty was examined using exploratory analyses that employed ordinal logistic regression, multiple linear regression, and restricted cubic splines (RCS). Stratified analyses were also conducted, dividing participants into subgroups based on polypharmacy, hypertension, diabetes mellitus, coronary heart disease, and alcohol status, to examine the association between LDL-C and frailty. Results The mean age of participants was 77.5 ± 6.4 years. The prevalence of robust, pre-frailty, and frailty was 20.6%, 69.7%, and 9.6%, respectively. Adjusted ordinal logistic regression revealed a negative association between LDL-C and frailty (OR = 0.667, 95% CI = 0.489 to 0.909, P = 0.010). Multiple linear regression confirmed this association (β = -0.129, 95% CI = -0.245 to -0.012, P = 0.031). According to the RCS curve, the non-linear relationship between LDL-C and the level of frailty was not significant (P = 0.639). Stratified analyses demonstrated that LDL-C was significantly negatively associated with frailty in non-drinkers and in individuals without hypertension or diabetes mellitus. Conclusions Pre-frailty is prevalent among older adults aged ≥70 years, and the relationship between LDL-C and frailty was negative. These findings suggest that individualized lipid management in older adults may need to account for frailty status.