Objective  To conduct a target trial emulation (TTE) to explore the effect of regular consumption of "medicine and food homology" (MFH) medicinal plants on activities of daily living (ADL) among the Chinese elderly.

Methods  Data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Participants who entered the cohort in 2008, had normal ADL, and did not regularly consume medicinal ingredients at the age of 60 were selected as the study population. Follow-up data were collected from three surveys conducted between 2011 and 2018. Following the TTE framework, overlap weighting methods were used to emulate the randomization of a randomized controlled trial (RCT). Weighted Cox regression models were employed to investigate the effects of regular MFH consumption on ADL, sup-plemented by subgroup and multiple sensitivity analyses.

Results  A total of 10,782 participants were included. During the 10-year follow-up period, 1,535 (14.2%) participants developed ADL disability. In the population adjusted by cumulative stabilized weights, the regular consumption group showed a 31.7% reduction in the risk of ADL disability compared to the control group [HR=0.683, 95%CI (0.483, 0.966)]. This protective effect was more pronounced in the elderly aged ≥80 years [HR=0.654, 95%CI (0.451, 0.949)], females [HR=0.453, 95%CI (0.273, 0.754)] and individuals without comorbidities [HR=0.544, 95%CI (0.321, 0.922)]. Sensitivity analyses yielded results consistent with the primary analysis.

Conclusion  By emulating a target trial, this study demonstrates that regular consumption of MFH medicinal plants significantly reduces the risk of ADL disability in the elderly. Specifically, females and individuals without chronic diseases may derive greater benefits from the consumption of these medicinal plants.

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