Association of combined mobility and cognitive impairments with adverse health outcomes in adults aged 66 years: a nationwide cohort study.

Authors

Seon Young Ryu, Sojeong Park, Jiwoo Yun

Published in

Journal of Yeungnam medical science. Volume 43. Pages 67. Epub Sep 21, 2026.

Abstract

We examined whether cognitive frailty, defined as the coexistence of cognitive and mobility impairments, predicts the long-term risks of incident dementia and other adverse outcomes in a nationwide cohort of community-dwelling adults aged 66 years.
We analyzed 741,655 adults aged 66 years from the Korean National Health Insurance Service database (screening years, 2009-2012). Cognitive impairment was defined as a Korean Dementia Screening Questionnaire-Prescreening score of ≥4. Mobility impairment was defined as a Timed Up and Go (TUG) time of >10 seconds. The participants were classified into four groups: preserved mobility/cognitively normal (reference), preserved mobility/cognitive impairment, mobility impairment/cognitively normal, and mobility impairment/cognitive impairment (cognitive frailty). Cox models estimated hazard ratios (HRs) for all-cause mortality. Fine-Gray models estimated subdistribution HRs (SHRs) for dementia, disability, and long-term care service (LTCS) utilization, accounting for the competing risk of death.
Over a mean follow-up of 10.9±2.6 years, 84,220 participants (11.4%) developed dementia. Compared with the reference group, cognitive frailty was associated with higher dementia incidence (adjusted SHR, 1.74; 95% confidence interval [CI], 1.67-1.81). Cognitive frailty was also associated with elevated risks of death (adjusted HR, 1.34; 95% CI, 1.29-1.40), disability (adjusted SHR, 1.42; 95% CI, 1.34-1.49), and LTCS utilization (adjusted SHR, 1.44; 95% CI, 1.38-1.49).
Cognitive frailty defined by cognitive impairment and TUG-based mobility impairment, identified older adults with an increased long-term risk of dementia and other adverse health outcomes. This finding may serve as a practical screening marker during the transition to older age.

PMID:
42765301
Bibliographic data and abstract were imported from PubMed on 21 Sep 2026.

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