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Additional file 1: Supplementary Tables 1-6.

This paper attempts to understand and provide policy recommendations on the development and performance of the emerging elderly care system in the People’s Republic of China. The three-tiered elderly system in the country consists of home-based care as the core support, community-based care as necessary support, and residential care as supplementary support. The main policies and progress of the system are explained, including insights on how the government encourages private sector involvement. A key recommendation of this paper is the need for better integration of residential and home- and community-based care as part of the elderly care system.

Background: previous literature has reported that loneliness is a strong predictor of frailty risk, yet less is known about the role of loneliness in frailty transition types. In this study, we examined whether and how loneliness is related to frailty transition among Chinese old people. Methods: our study used participants (aged>=60) from 2008/2009, 2011/2012 and 2014 waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Loneliness was assessed by a single question asking how often the respondent feels lonely and grouped into three levels: never, seldom, and often. FRAIL Scale was created to measure physical frailty for our study, and frailty was also assessed by a broader definition of frailty index. Frailty transition as an outcome variable has been designed as two types according to the measurement of frailty.Results: greater loneliness at baseline reduced the possibility of remaining robust or prefrail physical frailty state after adjusting for confounding variables (3-year period: OR=0.78, pConclusion: old people with a high level of loneliness tend to be frail in the future, and greater loneliness is related to increased risk of worsening frailty and remaining frail. Male elderly with a high level of loneliness were more likely to suffer from frailty transition than female elderly in China.