Prospective association of social frailty with incident motoric cognitive risk syndrome among middle-aged and older adults

BACKGROUND: The prospective association between social frailty and motoric cognitive risk syndrome in China is understudied. OBJECTIVE: To investigate the prospective association between social frailty and motoric cognitive risk syndrome among Chinese middle-aged and older adults. METHODS: Data were derived from the China Health and Retirement Longitudinal Study, 2011-2015. The sample comprised 3373 adults aged ≥45 years without motoric cognitive risk syndrome at baseline (2011). Social frailty was constructed from five indicators and categorized into three levels: robust, pre-frail, and frail. Motoric cognitive risk syndrome was defined as concurrent slow gait and subjective cognitive complaint at the 2013 and/or 2015 follow-ups. Associations were estimated using Cox proportional hazards models with sequential adjustment. RESULTS: After multivariate adjustment, compared with the robust group, pre-frailty (HR 1.63; 95% CI 1.12-2.36) and frailty (HR 2.02; 95% CI 1.38-2.96) were associated with a higher risk of incident motoric cognitive risk syndrome. In sex-stratified analyses, associations were stronger in males, whereas among females only frailty was significantly associated with a higher risk. CONCLUSIONS: Social frailty was associated with subsequent motoric cognitive risk syndrome in Chinese middle-aged and older adults, supporting social-risk screening and interventions.