To explore the association between the chronic disease management index based on integrated chronic disease clinics and frailty in community-dwelling older patients with chronic diseases, so as to provide evidence for early prevention and control of frailty at primary healthcare institutions.

A convenience sampling method was used to recruit community-dwelling older patients with chronic diseases who were enrolled in the integrated chronic disease outpatient management program in Liangzhu Subdistrict, Hangzhou, from June to December 2025. A field survey was used to collect the patients’ general information, the Tilburg Frailty Indicator was used to assess their frailty status, and the patients’ chronic disease management index was extracted at the same time. Frailty-related indicators that were statistically significant in univariate analysis (Mann-Whitney U test, chi-square test, and Fisher's exact test) were included in a multivariable logistic regression model for further analysis. Receiver operating characteristic (ROC) curves were plotted to analyze the diagnostic performance of the chronic disease management index for frailty in community-dwelling older patients with chronic diseases.

A total of 161 community-dwelling older patients with chronic diseases were enrolled, including 45 frail patients (frailty group) and 116 non-frail patients (non-frailty group). There were statistically significant differences between the two groups in sex, age, weekly exercise frequency, types of chronic diseases, types of medications, and the chronic disease management index (P < 0.05 or P < 0.01). Logistic regression analysis showed that after adjusting for sex, age, weekly exercise frequency, types of chronic diseases, and types of medications, the chronic disease management index remained negatively associated with frailty (OR=0.845, 95%CI: 0.742-0.940, P < 0.01). ROC curve analysis showed that the area under the curve for the chronic disease management index in distinguishing frailty from non-frailty was 0.759 (95%CI: 0.680-0.839), with an optimal cutoff value of 81.25 points, a sensitivity of 84.4%, and a specificity of 59.5%.

The chronic disease management index is significantly negatively associated with frailty in community-dwelling older patients with chronic diseases. Primary healthcare institutions should pay close attention to older patients with chronic diseases who have low chronic disease management index scores, promptly conduct specialized frailty assessment and comprehensive intervention, and thereby delaying the progression of frailty.