Abstract
This study aimed to investigate the longitudinal association between the frailty index (FI) and motoric cognitive risk (MCR) syndrome among middle-aged and older adults, using nationally representative data from the China Health and Retirement Longitudinal Study. Data from the 2011 to 2013 China Health and Retirement Longitudinal Study waves were analyzed. A total of 3091 middle-aged and older adults aged ≥45 years were included in the study. Participants were categorized into the MCR and non-MCR groups. Multivariate logistic regression, restricted cubic spline regression, and subgroup analyses were performed to examine the association between FI and MCR. A mediation analysis assessed the role of depressive symptoms in this relationship. A significant association was observed between FI and MCR. Participants with an MCR exhibited higher FI levels than those without an MCR (P < .001). A positive linear relationship was identified between FI and MCR risk (P < .001). This association remained stable across all subgroups examined (P for nonlinearity = .924). Furthermore, depressive symptoms mediated the relationship between frailty and MCR, accounting for 32.1% of the total effect (P < .05). Our findings suggest a positive linear association between frailty and MCR prevalence in middle-aged and older Chinese adults, potentially mediated in part by depression. Incorporating frailty and depression assessments into geriatric evaluations may facilitate earlier identification and targeted interventions for individuals at an increased risk of MCR in aging populations.