Cognitive frailty is considered a clinical entity associated with a high risk for adverse health outcomes. However, its clinical significance remains poorly understood. This study investigated the association between cognitive frailty and risk for functional disability among community-dwelling older adults. In total, 1,597 Japanese adults aged ≥ 65 years that were free of dementia and functional disability at baseline were prospectively followed for 10 years. Cognitive frailty was defined as the presence of both physical frailty (using Cardiovascular Health Study criteria) and cognitive impairment (Mini-Mental State Examination score < 26 points). Functional disability was identified using Japan’s Long-term Care Insurance System database. Cox proportional hazard models were used to estimate the hazard ratios (HR) for cognitive frailty on the risk for functional disability. Functional disability was identified in 488 participants during follow-up. A multiplicative interaction effect between cognitive impairment and physical frailty on the risk of disability was observed (p = 0.045). Compared with the robust group, the multivariable-adjusted HRs (95% confidence interval) for functional disability were 3.70 (2.37‒5.77) for cognitive frailty, 2.51 (1.81‒3.47) for physical pre-frailty with cognitive impairment, 2.16 (1.42‒3.29) for cognitive impairment only, 1.95 (1.36‒2.80) for physical frailty only, and 1.94 (1.53‒2.46) for physical pre-frailty only. These associations remained after adjusting for the competing risk for death and in sensitivity analyses to minimize potential reverse causality. Cognitive frailty is associated with an increased risk for functional disability in community-dwelling older adults. Cognitive frailty may be a clinically important target for the prevention of functional disability.

认知衰弱被认为是一种与不良健康结果的高风险相关的临床实体。然而，其临床意义仍然知之甚少。本研究调查了社区老年人认知衰弱与功能障碍风险之间的关联。总共对 1,597 名年龄在 65 ≥ 岁之间的日本成年人进行了为期 10 年的前瞻性随访，这些成年人在基线时没有痴呆和功能障碍。认知虚弱被定义为同时存在身体虚弱 （使用心血管健康研究标准） 和认知障碍 （简易精神状态检查评分 < 26 分）。使用日本的长期护理保险系统数据库确定功能障碍。使用 Cox 比例风险模型估计认知衰弱对功能障碍风险的风险比 （HR）。在随访期间，在 488 名参与者中发现了功能障碍。观察到认知障碍和身体虚弱对残疾风险的乘法交互作用 （p = 0.045）。与稳健组相比，功能障碍的多变量调整 HR（95% 置信区间）为认知衰弱 3.70 （2.37\u20125.77），身体衰弱前期伴认知障碍 2.51 （1.81\u20123.47），仅认知障碍 2.16 （1.42\u20123.29），仅身体虚弱 1.95 （1.36\u20122.80），仅身体衰弱 1.94 （1.53\u20122.46）。在调整了竞争性死亡风险和敏感性分析以尽量减少潜在的反向因果关系后，这些关联仍然存在。认知衰弱与社区老年人功能障碍风险增加有关。 认知衰弱可能是预防功能障碍的临床重要目标。