# Cognitive frailty and its influencing factors in the elderly rural community residents of inner Mongolia, China

## TL;DR

This study examines cognitive frailty in elderly rural residents of Inner Mongolia, finding that lower education, income, and physical activity are linked to higher risk.

## Contribution

The study identifies modifiable risk factors for cognitive frailty in a rural Chinese elderly population.

## Key findings

- The prevalence of cognitive frailty in the study population was 9.27%.
- Lower educational attainment and lack of exercise were strongly associated with higher cognitive frailty risk.
- Higher grip strength and lower SARC-F scores were protective against cognitive frailty.

## Abstract

As a subtype of frailty, cognitive frailty (CF) has great significance on adverse outcomes in the elderly. The purpose of this study was to examine the prevalence of CF and the factors that contribute to it in an older population residing in rural communities in Inner Mongolia, China. Additionally, we aimed to identify potentially modifiable factors associated with CF to inform early intervention strategies for this population.

This was a cross-sectional survey of older people living in rural communities in Inner Mongolia, China (n = 885), who had not been initially diagnosed with dementia(September to October 2024). According to the questionnaire results, the participants were divided into three groups: CF (cognitive frailty), PCF (pre-cognitive frailty), and Robust. Using the Mini-Mental State Examination (MMSE < 25) scale, elderly individuals were divided into two categories: non-cognitive impairment (NCI) and cognitive impairment (CI).The FRAIL Scale Phenotype (FP ≥ 3) scale was used to measure non-physical frailty (NPF) and physical frailty (PF). Thus, the participant groups were defined as follows: PCF (NPF + CI or PF + NCI), CF (PF + CI), and Robust (NPF + NCI).

The prevalence of CF was 9.27%. In the ordinal regression analysis, lower educational attainment was associated with higher risk, with Illiterate (OR = 5.378, 95% CI: 3.607–8.019, p < 0.001) and Primary education (OR = 1.689, 95% CI: 1.180–2.416, P = 0.004) categories showing significant effects. Participants with a family income of 10,000–19,999 yuan had higher odds (OR = 1.734, 95% CI: 1.193–2.520, P = 0.004). Without exercise was positively associated with higher risk (OR = 1.514, 95% CI: 1.084–2.114, P = 0.015), while greater grip strength was inversely associated (OR = 0.977, 95% CI: 0.957–0.998, P = 0.030). Additionally, higher scores on the simple five-item scoring questionnaire (SARC-F) significantly increased the odds (OR = 1.592, 95% CI: 1.432–1.771, P < 0.001).

This study reports the prevalence of CF in a rural community of Inner Mongolia. The data showed the relationships between CF and sociodemographic factors and physical condition. This study highlights the importance of comprehensive geriatric health care for elderly residents of Inner Mongolia.

KY2024060.

The online version contains supplementary material available at 10.1186/s12889-026-26230-w.