ORIGINAL RESEARCH article
Front. Public Health
Sec. Aging and Public Health
This article is part of the Research TopicBiomechanics of Aging: Advances in Exercise and Intervention Strategies for Older Adult WellnessView all 20 articles
Multimorbidity Patterns and Cognitive Frailty in Adults Aged Over 50 Years: China Perspective
Provisionally accepted
- Department of Geriatrics, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Introduction: The multimorbidity underlying in cognitive frailty remain poorly understood. Methods: A cross-sectional study was performed in non-dementia Chinese aged over 50 years, Cognitive frailty (cognitive impairment and slow gait [SG]). Cardiovascular and cerebrovascular diseases (CCVD) (heart disease, type 2 diabetes, hypertension, hyperlipidemia and cerebral infarction). Continuous variables were evaluated using one-way analysis of variance (ANOVA). Categorical variables were assessed using the chi-square test. Pairwise comparisons were performed using the Bonferroni-corrected column proportion test (z-test). Multiple logistic regression analysis was conducted to identify factors associated with cognitive frailty. Results: A cross-sectional study included 571 males and 1,182 non-demented Chinese aged ≥50 years, categorized into 6 groups: normal, SG, subjective cognitive decline alone (SCD-A), mild cognitive impairment alone (MCI-A), subjective cognitive decline with slow gait (SCD-SG), and mild cognitive impairment with slow gait (MCI-SG). Cognitive frailty was defined as cognitive impairment plus SG. Walking speed and hand grip strength were lower in SG, SCD-SG, and MCI-SG groups (P<0.05). SCD-SG and MCI-SG groups had higher prevalence of ≥3 chronic conditions (P<0.05); SCD-SG and MCI-SG groups showed higher ≥3 CCVD (9.5%, 9.2%; P<0.05) in female. SCD-SG group had higher risk of 1-2 chronic conditions (OR=1.81, 95%CI=1.06-3.07) and ≥3 chronic conditions (OR=3.79, 95%CI=1.96-7.36). 2 Conclusion: Cognitive frailty in Chinese aged ≥50 years increases risk of ≥3 chronic diseases, with SCD-SG group at highest risk, highlighting the need for attention to cognitive frailty and multimorbidity. Contributions to the literature SCD-SG carries the highest risk for multimorbidity (>2 chronic diseases) among cognitive frailty phenotypes in Chinese adults aged over 50, surpassing MCI with SG (MCI-SG). Co-presence of cognitive decline and SG is a critical clinical marker significantly associated with elevated risk for multiple age-related chronic diseases. Interventions enhancing physical activity/walking speed in at-risk adults ≥50 could concurrently prevent Alzheimer's disease and mitigate chronic multimorbidity burden.
Keywords: multimorbidity, Slow Gait, cognitive frailty, aged over 50 years, MCI (mild cognitive impairment)
Received: 09 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Zhu, Ren, Hu, Jun and Guo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Jin Jun, jinjun222@sjtu.edu.cn
Qihao Guo, qhguo@sjtu.edu.cn
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