Cognitive frailty independently predicts hip fracture risk in older Chinese adults: a 10-year prospective analysis

作者：Xiaoming Zhang, Lihuan Chen, Rui Zeng, Fayi Xie, Aizhang Zhu, Ke Zhu, Tenghui Fan, Dongmei Ye, Wan Zhu, Mengxia Shi, Yi Xiao, 赖泽中, Yufei Zeng, Jiang Wang, Qing Li Dou, Yunzhi Yang · 发表于：Aging Clinical and Experimental Research · 年份：2026 · DOI：10.1007/s40520-026-03464-7 · 研究领域：Hip and Femur Fractures、Frailty in Older Adults、Bone health and osteoporosis research

Hip fractures represent a significant public health burden among aging populations, particularly in China, where they are driven by osteoporosis and falls. Cognitive frailty- defined as the coexistence of physical frailty and mild cognitive impairment in the absence of dementia has been associated with increased fall risk; however, its relationship with hip fractures remains poorly understood. This study aimed to investigate the association between cognitive frailty and hip fractures risk among older Chinese adults. Data were derived from the China Health and Retirement Longitudinal Study (CHARLS), a nationally representative cohort. The cross-sectional study included 3,870 participants aged ≥ 60 years, while 3,797 participants were followed longitudinally over 10 years (2011–2020). Cognitive frailty was operationally defined as concurrent presence of cognitive impairment -assessed through word recall, the telephone interview for cognitive status (TICS-10), and figure drawing and physical frailty, defined by (Fried Frailty Phenotype (FFP) score ≥ 3. Logistics regression and cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs), adjusting for sociodemographic and health-related covariates. Sensitivity analyses and subgroup analyses were conducted to validate the robustness of the findings. The mean age of the cohort was 66.89 years, and 172 participants (4.53%) developed incident hip fractures during follow-up. Both cross...