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Association between physical performance and cognitive frailty in middle-aged and older adults undergoing maintenance hemodialysis: a cross-sectional study
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  • Published: 17 February 2026

Association between physical performance and cognitive frailty in middle-aged and older adults undergoing maintenance hemodialysis: a cross-sectional study

  • Zihan Yi1 na1,
  • Wei Qing2 na1,
  • Zhaohua Zou2,
  • Xingying Xu2,
  • Xinjie Cheng2 &
  • …
  • Zikejimu Sun1 

Scientific Reports , Article number:  (2026) Cite this article

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We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Health care
  • Medical research
  • Nephrology
  • Neurology

Abstract

Cognitive frailty (CF), defined as the coexistence of physical frailty and cognitive impairment, may be reversible under certain conditions. Identifying factors associated with CF in patients undergoing maintenance hemodialysis (MHD) is important for early recognition and risk stratification. This cross-sectional study examined the association between physical performance and CF in 282 Chinese MHD patients aged ≥ 45 years. CF was assessed using standardized cognitive and frailty assessment tools, and physical performance was evaluated using handgrip strength (HGS), gait speed (GS), the Five Times Sit-to-Stand Test (STS5), and the Timed Up and Go Test (TUGT). Logistic regression and receiver operating characteristic (ROC) curve analyses were performed. CF was identified in 44 participants (15.6%). Higher HGS (OR = 0.898, 95% CI: 0.835–0.965, P = 0.003) and faster GS (OR = 0.012, 95% CI: 0.001–0.253, P = 0.004) were independently associated with lower odds of CF, whereas longer STS5 completion time was associated with higher odds of CF (OR = 1.222, 95% CI: 1.096–1.363, P < 0.001). TUGT was not significantly associated with CF (OR = 1.125, 95% CI: 0.996–1.271, P = 0.057). All four physical performance indicators demonstrated high discriminatory performance for CF, with AUC values ranging from 0.921 to 0.931. In conclusion, three commonly used physical performance measures (HGS, GS, and STS5) were significantly associated with the presence of CF in Chinese MHD patients. These readily obtainable indicators may be useful for screening CF in clinical settings, supporting the role of physical performance assessment in this high-risk population.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We sincerely thank the patients undergoing MHD whose participation made this study possible. We are also grateful to the research and clinical experts for their valuable guidance and insights throughout the study. Special thanks go to the frontline healthcare professionals for their dedicated support during data collection and implementation. Finally, we appreciate the contributions of the statistician, whose expertise in data analysis was essential to the accuracy and reliability of the study findings.

Funding

This research was supported by Health Commission of Sichuan Province (grant number: 21PJ173) and Sichuan Nursing Vocational College (grant number: 2025ZRY44).

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Author notes

  1. These authors contributed equally: Zihan Yi and Wei Qing.

Authors and Affiliations

  1. Department of Nursing, People’s Hospital of Deyang City, No. 173, Section 1, Taishan North Road, Deyang, 618000, Sichuan Province, China

    Zihan Yi & Zikejimu Sun

  2. Nephrology Department, People’s Hospital of Deyang City, No. 173, Section 1, Taishan North Road, Deyang, 618000, Sichuan Province, China

    Wei Qing, Zhaohua Zou, Xingying Xu & Xinjie Cheng

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Contributions

Z.Y. and Z.S. contributed to the conceptualization and formal analysis. Z.Z. was responsible for data curation and contributed to visualization. W.Q. and Z.Y. acquired funding and participated in project administration. Z.Z., X.X., and X.C. conducted the investigation. Z.Y. developed the methodology and drafted the original manuscript. W.Q. and Z.S. provided supervision. Z.S. and Z.Y. reviewed and edited the manuscript. All authors have read and approved the final version of the manuscript.

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Correspondence to Zikejimu Sun.

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Yi, Z., Qing, W., Zou, Z. et al. Association between physical performance and cognitive frailty in middle-aged and older adults undergoing maintenance hemodialysis: a cross-sectional study. Sci Rep (2026). https://doi.org/10.1038/s41598-026-38413-x

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  • Received: 09 July 2025

  • Accepted: 29 January 2026

  • Published: 17 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-38413-x

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Keywords

  • Cognitive frailty
  • Maintenance hemodialysis
  • Physical performance
  • Middle-aged and older adults
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