To investigate the prevalence characteristics of motor-cognitive risk syndrome (MCR) among community-dwelling elderly aged ≥65 and analyze its related factors, providing evidence forMCR early prevention and intervention.

A total of 5 659 community-dwelling elderly aged ≥65 years were selected from the HMACS cohort. MCR was assessed through questionnaires, physical examinations, and neuropsychological evaluations. The epidemiological characteristics were described, and multivariate logistic regression analysis was conducted to identify influencing factors, with stratified analysis by sex and age.

Among the 5 659 older adults, 719 were diagnosed with MCR, with a crude prevalence rate of 12.71%. After standardization based on the data of the 7th National Population Census in 2020, the total standardized prevalence rate was 18.52%. The prevalence rate of MCR increased with age, which was higher in females (14.13%) than in males (11.32%), and higher in rural areas (30.17%) than in urban areas (6.72%). After adjusting for confounding factors,multivariate logistic regression analysis showed that medium SES (OR=0.371, 95%CI: 0.289-0.474), high SES (OR=0.361, 95%CI: 0.279-0.464), close neighborhood relationships (OR=0.648, 95%CI: 0.538-0.780), a balanced diet (OR=0.709, 95%CI: 0.569-0.887), and intellectual activities (OR=0.671, 95%CI: 0.551-0.817) were associated with a lower prevalence of MCR. Advanced age, female gender, living alone, and cardiometabolic comorbidities were associated with a higher prevalence of MCR (P<0.05). Stratified analysis showed that cardiovascular metabolic comorbidities were only associated with a high MCR prevalence in men (OR=1.523, 95%CI: 1.167-1.987), while living alone was only associated with a high MCR prevalence in women (OR=1.515, 95%CI: 1.085-2.059).

This cross-sectional study shows that the prevalence of MCR among community-dwelling elderly aged 65 and above is relatively high. Its occurrence is independently associated with various social, lifestyle, and health factors, and exhibits significant differences across gender and age strata. Therefore, early screening should be conducted for high-risk populations, and comprehensive interventions should be implemented to slow the progression of MCR and maintain the physical and mental health of the elderly.