Dynamic changes in frailty status and the risk of incident low back pain: a nationwide cohort study based on the China health and retirement longitudinal study

Frailty is a dynamic and powerful predictor of incident LBP. Progression towards frailty significantly elevates LBP risk, while recovery is protective. These findings establish a temporal relationship, positioning frailty as a critical, modifiable target for LBP prevention. Integrating frailty assessment into routine clinical care may be a key strategy to reduce the burden of LBP in aging populations.