["Geriatrics &Gerontology International, Volume 26, Issue 5, May 2026. ", "\nFrailty is independently associated with both prevalent and incident chronic liver disease in Chinese adults aged ≥ 45 years. A clear dose–response relationship was observed, with significantly increased risk already evident in the prefrailty stage.\n\nABSTRACT\n\nBackground\nChronic liver disease (CLD) is a significant public health burden in China. This study aimed to investigate the unclear correlation between frailty—characterized by diminished physiological reserves—and CLD risk among middle‐aged and elderly Chinese adults.\n\n\nMethods\nUsing data from the China Health and Retirement Longitudinal Study (CHARLS), we evaluated associations between the frailty index (FI) and CLD via cross‐sectional and longitudinal analyses. Multivariable logistic regression and Cox proportional hazards models were used to assess CLD prevalence and incidence, respectively. Restricted cubic spline, Kaplan–Meier, and sensitivity analyses were also performed.\n\n\nResults\nThe study included 16 936 participants for cross‐sectional and 14 901 for longitudinal analyses. Cross‐sectionally, frailty showed a significant dose–response relationship with CLD prevalence: in fully adjusted models, pre‐frail (OR = 1.84, 95% CI: 1.49–2.28) and frail (OR = 3.14, 95% CI: 2.46–4.02) groups had elevated risks compared with nonfrail individuals. Longitudinally, baseline frailty independently predicted incident CLD (prefrail: HR = 1.35, 95% CI: 1.16–1.56; frail: HR = 1.76, 95% CI: 1.45–2.12). Additionally, each 10‐unit FI increase raised CLD prevalence (OR = 1.29, 95% CI: 1.22–1.37) and incidence (HR = 1.15, 95% CI: 1.09–1.22) risks.\n\n\nConclusions\nIn middle‐aged and older Chinese adults, frailty exhibits a dose–response association with CLD prevalence and incidence, with notably elevated risks even in pre‐frailty. Frailty assessment may identify high‐risk populations, offering new avenues for primary prevention and integrated interventions amid aging‐related liver diseases.\n\n"]