Prevalence of Locomotive Syndrome and Its Association with Physical Activity, Frailty, and Cognitive Status Among Community-Dwelling Older Adults in Thailand

This cross-sectional study included 112 community-dwelling older adults aged ≥ 60 years residing in Tha Sala District, Nakhon Si Thammarat Province, Thailand, recruited using a community-based quota sampling approach. Locomotive syndrome (LS) was assessed using the two-step test and classified according to the Japanese Orthopaedic Association criteria. Physical activity was evaluated using the Thai version of the Global Physical Activity Questionnaire across work-related, transportation-related, and recreational domains. Frailty and cognitive status were assessed using the Thai version of the FRAIL questionnaire and the Montreal Cognitive Assessment, respectively. Binary logistic regression analysis was used to examine associations. The prevalence of LS was 74.1%, with 37.5%, 33.0%, and 3.6% in participants classified as having LS stages 1, 2, and 3, respectively. Transportation-related physical activity was significantly associated with lower odds of LS. Frailty and mild cognitive impairment frequently coexisted with LS but were not independently associated with LS after adjustment for age and sex. Transportation-related physical activity emerged as a key protective factor, highlighting the importance of habitual mobility in daily life. Our findings suggest that LS overlaps with, but is not identical to, frailty and cognitive decline in relatively robust community settings. Early screening and mobility-related physical activity may be crucial in preventing functional decline in rapidly aging societies.