[Influencing factors of cognitive frailty in urban community elderly based on Lasso regression]

To analyze the influencing factors of cognitive frailty in urban community elderly.

Using convenience sampling, we recruited 1086 elderly aged ≥65 years from two study sites(Dongying City, Shandong Province and Jiangbei District, Chongqing Municipality) between July 2022 and June 2023. Data collection included general demographic characteristics and dietary assessment using food frequency questionnaires. The assessment of cognitive frailty was conducted using the Fried frailty phenotype criteria combined with the Chinese version of the mini-mental state examination. Physical measurements and blood sample collection were performed. Variable selection was performed using Lasso regression, followed by Logistic regression analysis to identify factors associated with cognitive frailty among urban community elderly.

Among the 1086 elderly, a total of 270 cases(24.9%) had cognitive frailty. Significant differences were observed between the two groups regarding pension income and number of chronic conditions(P<0.05). The cognitive frailty rates decreased with the pension income and the number of chronic, the trend were statistically significant(P<0.05). Compared to non-cognitively frail elderly, those with cognitive frailty had significantly lower weekly intake frequencies of grains & tubers, fish/shellfish, eggs, fresh vegetables, and fruits(P<0.05), diastolic blood pressure, 6-meter walking speed, triglycerides, interleukin-6, albumin, vitamin B_(12), the abnormal rates of calf circumference and handgrip strength were significantly higher(P<0.05). Based on Lasso regression, 14 variables were selected: level of education, living arrangement, pension income, calf circumference, intake frequency of grains/tubers, fish/shellfish, dairy products, vegetables, and fruits, systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, and vitamin B_(12) levels. Multivariable Logistic regression analysis result showed that: adjusted for age, sex and level of education, revealed the following protective factors against cognitive frailty: a monthly pension of 4001-6000 RMB/month(OR=0.356, 95%CI 0.218-0.583), >6000 RMB/month(OR=0.542, 95%CI 0.302-0.971), fish/shellfish consumption(OR=0.815, 95%CI 0.682-0.973) and fruit intake(OR=0.955, 95%CI 0.914-0.998). The risk factors for cognitive frailty were co-residence(OR=2.038, 95%CI 1.065-3.903) and abnormal calf circumference(OR=2.196, 95%CI 1.591-3.031).

The prevalence of cognitive frailty among urban community elderly is high with multifactorial determinants.