Association of physical frailty, functional dependence, dysphagia, and depression with mild cognitive impairment in hospitalized older adults.

BACKGROUND: Geriatric syndrome assessment is of significant importance for health evaluation in hospitalized older adults. Physical frailty, functional dependence, dysphagia, and depression may coexist with mild cognitive impairment (MCI) and interact with one another. METHODS: A total of 1,665 hospitalized patients aged ≥60 years from June 2024 to March 2025 were included. MCI was diagnosed according to Petersen criteria. Geriatric syndromes were assessed using the Fried Frailty Phenotype, Barthel Index (ADL), GDS-15, and the Kubota Water Swallowing Test. LASSO regression was used for variable selection, and multivariable logistic regression models were constructed. ROC curves were used to evaluate predictive performance. RESULTS: Pre-frailty (OR = 5.90), mild ADL dependence (OR = 1.60), moderate-to-severe ADL dependence (OR = 6.01), depression (OR = 3.70), and abnormal Kubota Water Swallowing Test results (Grade II: OR = 2.71; Grade III: OR = 10.42; Grade IV/V: OR = 4.02) were all significantly associated with MCI (all P < 0.05). The combined model achieved an AUC of 0.773, significantly outperforming any single indicator (P < 0.001). CONCLUSIONS: Pre-frailty, functional dependence, depression, and dysphagia are independently and significantly associated with MCI in hospitalized older adults, with additive effects. These geriatric syndromes should serve as clinical warning signs for MCI screening, and comprehensive geriatric assessment facilitates early identification and intervention.