Risk Factor Analysis of Cognitive Frailty in Older Adults With Type 2 Diabetes Mellitus: A Cross-Sectional Study

Qingjuan Ren^*Shu NiuLei ZhiHongfang Liu

• Shijiazhuang People’s Hospital, Shijiazhuang, China

Background: Cognitive Frailty (CF), characterized by the co-occurrence of physical frailty and cognitive impairment without dementia, is a significant concern in older adults with Type 2 Diabetes Mellitus (T2DM). This study investigates the prevalence and risk factors of CF in this population, addressing the urgent need for early detection and intervention strategies. Methods: A cross-sectional study was conducted among 713 T2DM patients aged ≥65 years. Participants were assessed using the Clinical Dementia Rating (CDR) for cognitive function and Fried Frailty Phenotype (FP) criteria for physical frailty. CF was defined as CDR=0.5 and FP score ≥3. Multivariable logistic regression identified independent risk factors, adjusting for demographic and clinical variables. Results: The prevalence of CF was 24.3%. Cerebrovascular disease (OR: 2.39, 95% CI: 1.44-3.97) and peripheral arterial disease (OR: 1.74, 95% CI: 1.03-2.95) were significant risk factors, while higher education (OR 0.85, 95% CI 0.76-0.94) and later diabetes onset (OR: 0.93, 95% CI: 0.88-0.98) were protective. Early-onset diabetes significantly increased CF risk regardless of education level. Conclusion: This study highlights a markedly increased risk of CF in older adults with T2DM, especially in individuals with CVD, PAD, low education levels, or early-onset diabetes. Notably, early diabetes onset may override the protective effects of cognitive reserve, emphasizing the critical need for early metabolic and vascular risk management in this high-risk population. These findings support integrated screening for cognitive and physical frailty in diabetes care to enable timely interventions.