Prevalence and Associated Factors of Dual Physical and Cognitive Impairment Among Adults Aged 50 Years and Older with Cardiometabolic Conditions: A Cross-Sectional Study

Background: Dual impairment of physical and cognitive capacities is associated with adverse health outcomes in aging populations and may emerge during middle age. However, evidence on its prevalence and associated factors among adults with cardiometabolic conditions in primary care settings remains limited, particularly in Southeast Asia. This study aimed to determine the prevalence of dual impairment and identify factors associated with dual impairment among adults aged ≥50 years with cardiometabolic conditions. Methods: A cross-sectional study was conducted among adults aged ≥50 years who had at least one cardiometabolic condition and attended a primary care clinic at a university-affiliated health center in Northern Thailand between March 2024 and July 2025. Dual impairment was defined as impaired cognitive function, assessed using the Montreal Cognitive Assessment (MoCA), together with impaired physical function, defined as either slow gait speed or low handgrip strength. Multivariable logistic regression analysis was used to examine factors associated with dual impairment. Results: A total of 196 participants were included. The mean age was 69.08 ± 6.15 years, and 72.96% were female. The prevalence of dual impairment was 25.00%. In the primary fully adjusted model (Model 1), lower LDL-C was the only factor significantly associated with dual impairment (adjusted OR [aOR] = 0.98, 95% CI: 0.97–1.00, p = 0.021). In the secondary parsimonious model (Model 2), female sex was associated with higher odds of dual impairment (aOR = 2.48, 95% CI: 1.05–5.84, p = 0.038), whereas age was not statistically significant (aOR = 1.04, 95% CI: 0.99–1.10, p = 0.139). The inverse association between LDL-C and dual impairment remained significant in Model 2 (aOR = 0.98, 95% CI: 0.97–0.99, p = 0.020). Conclusions: Dual impairment was identified in approximately one-quarter of participants, representing a substantial burden among individuals with cardiometabolic conditions. The observed inverse association between LDL-C and dual impairment should be interpreted cautiously given the potential for reverse causation and residual confounding, as well as the lack of information on lipid-lowering medication use. The identified associations are exploratory and warrant confirmation in larger prospective multicenter studies.