Gender differences in the association between physical frailty and cognitive function among older adults: A cross-sectional study in rural Guizhou, China

To examine gender differences in the association between physical frailty and cognitive function among older adults in rural China. A total of 1,654 older adults (41.9% male) aged 60 years and above from rural areas of Guizhou Province, China, participated in the study. Cognitive function was assessed using the Chinese-adapted Mini-Mental State Examination (C-MMSE), and frailty status was determined based on Fried's frailty criteria. Multivariate linear regression analyses were conducted to examine the association between frailty and cognitive function, with sex-stratified analyses performed to explore gender-specific differences in these associations. Females exhibited a significantly higher prevalence of frailty (12.9% vs. 9.2%) and lower mean C-MMSE scores (19 vs. 24) compared to males (All P < 0.001). After adjustment, frailty was inversely associated with C-MMSE in both sexes.Among the five frailty phenotypes, only low physical activity (β =-1.156; 95% CI: -2.019 to -0.293; P = 0.002) and self-reported exhaustion or fatigue (β = -0.963; 95% CI:-1.658 to -0.269; P = 0.005) were significantly associated with lower C-MMSE scores in females. In women, the presence of any one or more frailty phenotypes was linked to cognitive decline, whereas in men, cognitive impairment was observed only when three or more frailty phenotypes were present. According to results from the study of older adults in rural Guizhou, there is a gender difference in the relationship between frailty and cognitive function, with women having a stronger association. These findings suggest that women's cognitive function is more susceptible to the effects of frailty, while more prospective research is needed to confirm this conclusion.