Association between visceral adiposity index, lipid accumulation products, and frailty in older Americans: the 2007–2018 NHANES cross-sectional study

The aim of this study was to investigate the relationship between visceral adiposity index (VAI) and lipid accumulation products (LAP) and frailty index (FI) in older Americans. Based on data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES), the study population consisted of 3,396 older adults aged 60 years and older with a mean age of 69.48 ± 6.76 years. The findings of weighted multivariate regression analysis demonstrated a strong correlation between the prevalence of frailty prevalence and greater VAI and LAP. In the fully adjusted model, the association of VAI with frailty remained significant, with an OR of 1.49 (95% CI: 1.26, 1.77; <i>p</i> < 0.0001.) The association of LAP with frailty was also significant, with an OR of 1.88 (95% CI: 1.55, 2.29; <i>p</i> < 0.0001). Further nonlinear analyses by generalized additive modeling (GAM) revealed significant nonlinear relationships between VAI and LAP and frailty, and the nonlinear effects were more pronounced in the female population. Subgroup analyses showed that the positive correlations between VAI and LAP and frailty were generalized across populations and there was no significant interaction in most subgroups. In addition, sensitivity analyses validated the robustness of these results, further confirming the conclusion of VAI and LAP as independent risk factors for frailty. Finally, ROC analysis showed that LAP outperformed VAI in predicting frailty, suggesting the potential of LAP in early screening for frailty. Overall, VAI and LAP are independent risk factors for frailty in the elderly population and have important clinical applications.