Background: Frailty and cognitive impairment are two common geriatric symptoms linking adverse health-related outcomes. However, cognitive frailty, a new definition defined by an international consensus group, has been shown to be a better predictor of increased disability, mortality, and other adverse health outcomes among older people than just frailty or cognitive impairment. This study estimated the prospective association between social support and subsequent cognitive frailty over 1 year follow-up, and whether psychological distress mediated the association. Methods: The data was drawn from a prospective repeated-measures cohort study on a sample of participants aged 60 and over. A total of 2785 older people who participated in both of the baseline and 1-year follow-up survey were included for the analysis. Cognitive frailty was measured by the coexistence of physical frailty and cognitive impairment without dementia. Control variables included sex, age, education, marital status, economic status, smoking status, alcohol drinking status, chronic conditions, and functional disability. Path analyses with logistic function were performed to examine the direct effects of social support (predictors) on subsequent cognitive frailty (outcome) at 1-year follow-up and the mediating role of psychological distress (mediator) in this link. Results: After adjusting for covariates and prior cognitive frailty status, social support was negatively associated with psychological distress (β = − 0.098, 95% CI = − 0.137 to − 0.066, P < 0.001) and was negatively associated with the log-odds of cognitive frailty (β = − 0.040, 95% CI = − 0.064 to − 0.016, P < 0.001). The magnitude of mediation effects from social support to cognitive frailty via psychological distress was a*b = − 0.009, and the ratio of a*b/(a*b + c’) was 24.32%. Conclusions: Lower social support is associated with increased rates of subsequent cognitive frailty over 1-year follow-up, and this link is partially mediated through psychological distress, suggesting that assessing and intervening psychological distress and social support may have important implications for preventing cognitive frailty among older people.

Background: Recognizing perceived stress as a modifiable risk factor, mindfulness-based programs show promise for stress mitigation in older adults with mild cognitive impairment (MCI). Objective: To assess the efficacy of a mindfulness-based contextual cognitive defusion training (M-bCCDT) program on perceived stress and other health outcomes, and to examine the reliable and clinically significance of these improvements at individual-level among older adults with MCI. Design: A two-arm, assessor-blinded randomized controlled trial. Settings and participants: 102 community-dwelling older adults with MCI. Methods: Participants were randomly allocated to either a M-bCCDT program (weekly 60-minute sessions for 8 weeks, followed by 12 weeks of unsupervised practice) or health promotion classes. Measures of perceived stress, memory function, global cognitive function, psychomotor speed and mindfulness awareness were collected at baseline (T0), 8-week (T1) and 20-week (T2). Intervention effects were assessed at a group level (Generalized Estimating Equation, GEE) and individual level (Reliable and Clinically Significant Changes, RCSC). Results: The M-bCCDT program demonstrated significant interaction effects in perceived stress compared to the wait-list control group by GEE analysis (βT1 = −3.686, 95% CI [−5.397, −1.976]; βT2 = −7.608, 95% CI [−9.387, −5.829]). Furthermore, this program also showed significant efficacy in memory function, psychomotor speed and mindfulness awareness. RCSC indicated that 30 participants (59%) in the intervention group showed statistically significant improvement in perceived stress at 8-week, with 7 (14%) clinically significant. This increased to 38 (75%) with 20 (39%) clinically significant at 20-week. Secondary outcomes also showed statistically and clinically significant improvements over time, but no improvement in global cognitive function at the individual level. Conclusions: The M-bCCDT program positively impacted perceived stress and mindfulness awareness in older adults with MCI, facilitating the improvements in memory and psychomotor speed, with these benefits sustained for 20 weeks. It offers a systematic approach for community healthcare providers in MCI stress management.

With the intensification of ageing, cognitive frailty has become a major public health issue. The underlying mechanisms of the association between informal

Background: Motoric cognitive risk syndrome (MCR), a pre‐dementia syndrome, is a risk factor for disability and mortality. However, few studies have examined the associations between sleep quality trajectories and MCR. This study aimed to explore the associations between sleep quality trajectories and MCR, and whether these associations vary by gender among Chinese rural older adults.Methods: We used three waves of follow‐up data (2019, 2020, and 2022) from the Shandong Rural Elderly Health Cohort (SREHC), including 2,168 participants aged 60 years or above. MCR was defined by the presence of subjective cognitive complaints and slow gait. The Pittsburgh Sleep Quality Index was used to assess sleep quality over the past month. We applied the group‐based trajectory modeling to identify latent groups and estimate sleep quality trajectories. Logistic regression models were performed to examine relationships between sleep quality trajectories and MCR by gender.Results: The prevalence of MCR was 13.9% among Chinese rural older adults. Four sleep quality trajectories among males and females were identified, including the normal stable group (male:55.4%; female: 35.4%), the improved quality group (male:23.4%; female: 17.6%), the declined quality group (male:13.0%; female: 25.2%), and the low stable group (male:8.3%; female: 21.8%). After adjusting for covariates, rural older females in the declined quality group (Odds Ratio [OR] = 1.81, 95% Confidence Interval [CI] = 1.19 ‐ 2.77) and the low stable group (OR = 1.65, 95% CI = 1.04 ‐ 2.60) were more likely to have MCR than those in the normal stable group. However, only the declined quality group (OR = 2.00, 95% CI = 1.10 ‐ 3.61) was associated with MCR among male rural older adults.Conclusion: Our findings suggest that declined sleep quality was associated with MCR among Chinese rural older males and females. Interventions are needed to focus on addressing sleep quality among rural older adults, which may help prevent MCR.