Multidimensional factors associated with cognitive impairment: the roles of depression, sarcopenia, frailty, and chronic diseases in community-dwelling older women

As population aging accelerates globally, cognitive impairment has emerged as a major public health concern, particularly among older women. This study aimed to examine the independent and combined associations of depression, sarcopenia, frailty, and chronic diseases with cognitive impairment in community-dwelling older women in South Korea. A total of 1,065 women aged ≥65 years were recruited from 13 cities. Cognitive function was assessed using the Mini-Mental State Examination for Dementia Screening. Depression, sarcopenia, and frailty were evaluated using the Geriatric Depression Scale-Short Form, Strength, Assistance in walking, Rising from a chair, Climbing stairs and Falls questionnaire, and Fried frailty criteria. Information on physician- diagnosed chronic diseases (diabetes, arthritis, and hypertension) was also collected. Continuous variables were analyzed using independent t-tests, and categorical variables were analyzed using chi-square tests. Multivariable logistic regression analyses were performed to identify factors associated with cognitive impairment, adjusting for age group, depression, diabetes, hypertension, arthritis, sarcopenia, and frailty. Participants with cognitive impairment exhibited significantly higher levels of depression, sarcopenia, frailty, and a greater prevalence of chronic diseases compared to those with normal cognition. In multivariable analyses, depression, diabetes, arthritis, sarcopenia, and frailty remained significantly associated with cognitive impairment. These findings indicate that cognitive impairment in older women is associated with a complex interplay of psychological, physical, and metabolic factors. Addressing modifiable conditions, particularly depression, sarcopenia, and frailty, may be important for reducing the burden of cognitive impairment.