Prevalence and predictive factors of cognitive impairment among hospitalized older adults in iran: a cross-sectional study, 2024.

BACKGROUND: Cognitive frailty (CF), defined by the IANA/IAGG criteria as the coexistence of physical frailty and cognitive impairment without dementia, is an emerging geriatric syndrome associated with disability and adverse health outcomes. AIMS: This study aimed to estimate the prevalence of CF and develop a prediction model among hospitalized older adults in Iran. METHODS: A cross-sectional survey was conducted on 300 patients aged ≥ 60 years admitted to Shahid-Beheshti Hospital, Kashan, between July and September 2024. Data were collected using structured interviews incorporating the Fried Frailty Phenotype, the Clinical Dementia Rating Scale, and a researcher-developed tool assessing demographic, clinical, nutritional, psychosocial, and economic factors. Descriptive statistics and multivariable logistic regression (backward method) were applied. RESULTS: The mean age of participants was 71.8 ± 8.0 years, and 54.3% were male. The prevalence of CF and potentially CF was 22.7% and 23%, respectively. Protective factors included positive self-rated health (OR = 0.179), non-smoking (OR = 0.150), higher handgrip strength (OR = 0.798), good nutritional status (OR = 0.330), larger mid-upper arm and calf circumferences, and adequate appetite (OR = 0.107). Conversely, higher BMI (OR = 1.315), physical inactivity (OR = 5.966), diabetes (OR = 3.692), comorbidities (OR = 8.77), frequent physician visits (OR = 6.974), stressful life events (OR = 4.764), and poor economic status (OR = 2.724) were associated with increased risk. The model demonstrated strong predictive validity (Nagelkerke R²=0.678; Specificity = 0.921). CONCLUSIONS: CF is prevalent among hospitalized older adults in Iran and is strongly influenced by modifiable factors. Early detection and multidomain interventions-targeting nutrition, physical activity, chronic disease control, and psychosocial well-being-may prevent CF and improve quality of life in this vulnerable group.