Abstract: Objective To explore whether cognitive frailty increases the risk of falls 5 years later in elderly Chinese population. Methods The data were collected from the Rugao Aging Cohort. Fried frailty phenotype was used to evaluate frailty. Those who met ≥3 of the five criteria were defined as frailty, those who met 1-2 criteria were defined as pre-frailty, and those who did not meet any criteria were considered to be robust. The revised Hasegawa Dementia Scale(HDS-R) was used to evaluate cognitive function. Excluding severe cognitive impairment (HDS-R≤10), the lowest quartile of scores was cognitive impairment. Those with both frailty and cognitive impairment were defined as cognitive frailty. Binary logistic regression was used to analyze frailty and falls risk at 5-year follow-up, and explore the effect of cognitive frailty (frailty plus cognitive function assessment) on falls risk. Results This study included 962 subjects with a mean age of 74.7±3.7 years at baseline, including 526 females. After 5 years of follow-up, 134 people experienced falls in the last year of following up . The incidence of falls was higher in female, illiterate and unmarried subgroups. Logistic regression analysis showed that the frail subjects at baseline were more likely to fall(OR=4.360,95% CI=1.955-9.722), and those with cognitive frailty had a higher risk of fall than those robust without cognitive impairment (OR=6.000,95% CI=1.935-18.603). After adjusting for covariates, the higher five-year falls risk for cognitive frailty remained statistically significant (OR=6.736,95% CI=1.897-23.922, P＜0.05). Conclusions Cognitive frailty is significantly correlated with a higher risk of falls after 5 years. The assessment of cognitive frailty is important for assessing the risk of falls in older adults.

Key words: frailty, cognitive frailty, falls risk factors, longitudinal study