Maturitas · Jan 25, 2026

Association of social frailty and cognitive domain trajectories in middle-aged and older adults in China: A population-based cohort study from a network perspective

By Wang X, Si H, Li Y et al.

OBJECTIVE: The association between social frailty and the long-term trajectories of cognitive domains remains understudied in Chinese middle-aged and older adults. This study explores this association using data from a nationwide longitudinal study. METHODS: This study analyzed data obtained from the 2011-2020 waves of the China Health and Retirement Longitudinal Study. Trajectories in the three cognitive domains of global cognition, episodic memory, and executive function were determined through group-based trajectory modeling. Logistic regression models were employed to assess the associations between social frailty (classified as social frailty, pre-social frailty or robust) and the identified trajectories of global cognition, episodic memory, and executive function. In addition, network analysis was conducted to detect central nodes. RESULTS: A total of 7961 participants were included. The group-based trajectory modeling identified two distinct trajectories for global cognition, episodic memory, and executive function: a persistently low trajectory and a persistently high trajectory. Compared with the robust group, the pre-social frailty and social frailty groups were associated with higher odds of having a persistently low trajectory for global cognition, episodic memory, and executive function (pre-social frailty: odds ratio (OR) = 1.37, 95% confidence interval (CI) 1.22, 1.54, for global cognition; OR = 1.31, 95% CI 1.17, 1.46, for episodic memory; OR = 1.40, 95% CI 1.25, 1.58, for executive function; social frailty: OR = 1.86, 95% CI 1.45, 2.40, for global cognition; OR = 1.74, 95% CI 1.34, 2.27, for episodic memory; OR = 1.89, 95% CI 1.47, 2.44, for executive function). Moreover, network analysis revealed "loneliness" to be the most influential node in the network. CONCLUSIONS: These findings underscore the relevance of social frailty and loneliness to cognitive trajectories and support further research to evaluate whether interventions that enhance social support and reduce loneliness can improve cognitive outcomes in at-risk populations.

doi.org/10.1016/j.maturitas.2026.108852PubMed 41610540Populations