Association between locomotive syndrome and pre-frailty in community-dwelling older adults: A cross-sectional study

In super-aged societies, preventing frailty is a key public health priority to ensure longer, healthier lives. Locomotive syndrome (LS), defined as impaired mobility because of musculoskeletal dysfunction, is a modifiable risk factor for frailty. However, the relation between LS severity and prefrailty has not yet been fully elucidated. This study sought to clarify whether the degree of LS is related to pre-frailty among community-dwelling older adults. This cross-sectional analysis included data from the DETECt-L cohort (2021–2024). The severity of LS was evaluated in adults aged 65 years and older using three measures: the two-step test, the stand-up test, and the 25-item Geriatric Locomotive Function Scale (GLFS-25). Pre-frailty was assessed using the Japanese adaptation of the Cardiovascular Health Study criteria. The association between LS severity and pre-frailty was analyzed using binary logistic regression, with adjustments for age, sex, body mass index, back and knee pain, and history of falls. Among 512 participants, the prevalence of pre-frailty increased with LS severity. Compared with participants in the non-LS, the proportion of pre-frailty was higher in LS stage 2 (OR: 2.184, 95% CI: 1.094–4.358, P = 0.027), and the same was true for LS stage 3 (OR: 2.254, 95% CI: 1.032–4.922, P = 0.041). In independently living older adults, LS stage 2 or higher was significantly associated with pre-frailty. Preventing the transition from stage 1 to stage 2 may help reduce prefrailty risk and support healthy aging. Early orthopedic management of LS could serve as a strategic approach to mitigate frailty in super-aged societies.