Cognitive Impairment with Modified Self-Reported Physical Frailty among Middle-Aged and Older Adults in China: A Harmonized Repeated Cross-Sectional Analysis of CHARLS 2013, 2015 and 2018

GUAN Wenbiao

Abstract

Background: This study estimated the prevalence and correlates of cognitive impairment with modified self-reported physical frailty among middle-aged and older Chinese adults. Methods: Harmonized repeated cross-sectional data from CHARLS 2013, 2015, and 2018 were analyzed; the 2020 wave was excluded because comparable walking and lifting items were unavailable. Cognition was scored from orientation, serial subtraction, figure drawing, and immediate and delayed recall, and education-specific impairment cutoffs were derived from weighted 2013 20th percentiles. Modified physical frailty was defined as at least two of exhaustion, slowness, and weakness. Weighted prevalence, age-sex standardization, missing-data sensitivity analyses, and weighted GEE logistic models were used. Results: The analytic sample included 24437 observations from 13588 individuals. Weighted prevalence was 8.29% in 2013, 10.50% in 2015, and 16.93% in 2018. Older age, female sex, and higher depressive-symptom burden were associated with higher odds of cognitive frailty. Conclusions: Cognitive impairment with modified self-reported physical frailty affected about one in ten middle-aged and older Chinese adults, emphasizing the need for comparable measurement and transparent missing-data handling.

Keywords

Cognitive frailtyPhysical frailtyCognitive impairmentCHARLS

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