Prevalence and associated factors of cognitive frailty among community dwelling older adults of lower socioeconomic status stratified by sex

Cognitive frailty (CF) is a complex syndrome involving physical frailty and mild cognitive impairment (MCI), with additional contributing factors. While lower socioeconomic status (SES) and sex-specific ageing pathways are recognized as influential, their associations with CF remain underexplored. The objective of this study is to examine the prevalence of CF and its associated factors among community dwelling older adults with lower SES, with analyses conducted overall and stratified by sex. A cross sectional design was employed involving 255 community dwelling older adults attending senior citizen activity centers. CF was determined using Fried’s Frailty Phenotype in combination with the Clinical Dementia Rating (CDR) Scale. Data collection encompassed sociodemographic characteristics, health conditions, cognitive performance, physical and functional status, nutritional indicators, psychosocial measures, and health related quality of life (HRQoL). Hierarchical binary logistic regression identified factors associated with CF for the total sample and by sex. The overall prevalence of CF within this sample was 38.4% (41.1% in females; 30.2% in males). Significant factors associated with CF included poorer immediate recall verbal memory (p = 0.003), attention and working memory (p < 0.001), instrumental functional ability (p = 0.024), and lower HRQoL in usual activities (p = 0.025). Among males, CF was linked to poorer immediate recall verbal memory (p = 0.012) and attention/working memory (p = 0.036), while in females, it was associated with lower education (p = 0.017), poorer attention/working memory (p < 0.001), and lower HRQoL in mental function (p = 0.007). CF is prevalent among socioeconomically disadvantaged older adults, with sex-specific risk factors. Targeted, cost-effective interventions focusing on cognitive training, education, and mental wellbeing are crucial for prevention and reversal, particularly in vulnerable female populations. High cognitive frailty (CF) prevalence in older adults with lower SES: 38.4% overall; higher in females (41.1%) than males (30.2%). Sex-specific CF risks: memory decline in males; low education and poor mental health in females. Targeted interventions such as cognitive training and education may reduce CF risk in this population.