Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-30T21:52:49.488Z Has data issue: false hasContentIssue false
  • English
  • Français

Association of cognitive impairment with frailty in community-dwelling older adults

Published online by Cambridge University Press:  23 October 2013

Eun Sook Han ,
Yunhwan Lee  and
Jinhee Kim
Eun Sook Han
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea Seoul National University Bundang Hospital, Seong-Nam, Republic of Korea
Yunhwan Lee*
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
Jinhee Kim
Affiliation:
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea Institute on Aging, Ajou University Medical Center, Suwon, Republic of Korea
*
Correspondence should be addressed to: Professor Yunhwan Lee, Department of Preventive Medicine and Public Health, Ajou University School of Medicine, 164 World cup-ro, Youngtong-gu, Suwon 443–380, Republic of Korea. Phone: +82-31-219-5085; Fax: +82-31-219-5084. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Frailty is highly prevalent in older people, but its association with cognitive function is poorly understood. The aim of this study was to examine the association between cognitive function and frailty in community-dwelling older adults.

Methods:

Data were from the 2008 Living Profiles of Older People Survey, comprising 10,388 nationally representative sample aged 65 years and older living in the community in South Korea. Frailty criteria included unintentional weight loss, exhaustion, weakness, low physical activity, and slow walking speed. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. Multinomial logistic regression models were constructed with frailty status regressed on cognitive impairment and subdomains of cognitive function, adjusting for covariates.

Results:

Those who were frail showed a higher percentage of cognitive impairment (55.8% in men, 35.2% in women) than those who were not (22.1% in men, 15.6% in women). Cognitive impairment was associated with an increased risk of frailty in men (odds ratio (OR) = 1.81, 95% confidence interval (CI): 1.25–2.60) and women (OR = 1.69, 95% CI: 1.25–2.30) even after controlling for all covariates. Among the subdomains of cognitive function, time orientation, registration, attention, and judgment were associated with a lower likelihood of frailty in both men and women after adjusting for confounders. Among women higher scores on recall, language components, and visual construction were also significantly associated with lower odds of frailty.

Conclusions:

Cognitive impairment was associated with a higher likelihood of frailty in community-dwelling older men and women. Total scores and specific subdomains of cognitive function were inversely associated with frailty.

Keywords

frailtycognitioncognitive impairmentolder adults
Type
Research Article
Information
International Psychogeriatrics , Volume 26 , Issue 1 , January 2014 , pp. 155 - 163
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abellan, v. K. G., Rolland, Y., Houles, M., Gillette-Guyonnet, S., Soto, M. and Vellas, B. (2010). The assessment of frailty in older adults. Clinics in Geriatric Medicine, 26, 275.Google Scholar
Ahmed, N., Mandel, R. and Fain, M. J. (2007). Frailty: an emerging geriatric syndrome. American Journal of Medicine, 120, 748–753.CrossRefGoogle ScholarPubMed
Auyeung, T. W., Lee, J. S., Kwok, T. and Woo, J. (2011). Physical frailty predicts future cognitive decline – a four-year prospective study in 2737 cognitively normal older adults. Journal of Nutrition, Health and Aging, 15, 690–694.CrossRefGoogle ScholarPubMed
Ávila-Funes, J. A.et al. (2009). Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the Three-City Study. Journal of the American Geriatrics Society, 57, 453–461.CrossRefGoogle ScholarPubMed
Boyle, P. A., Buchman, A. S., Wilson, R. S., Leurgans, S. E. and Bennett, D. A. (2010). Physical frailty is associated with incident mild cognitive impairment in community-based older persons. Journal of the American Geriatrics Society, 58, 248–255.CrossRefGoogle ScholarPubMed
Buchman, A. S., Boyle, P. A., Wilson, R. S., Tang, Y. and Bennett, D. A. (2007). Frailty is associated with incident Alzheimer's disease and cognitive decline in the elderly. Psychosomatic Medicine, 69, 483–489.CrossRefGoogle ScholarPubMed
Buchman, A. S., Schneider, J. A., Leurgans, S. and Bennett, D. A. (2008). Physical frailty in older persons is associated with Alzheimer disease pathology. Neurology, 71, 499–504.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). Mini-Mental State: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Fried, L. P.et al. (2001). Frailty in older adults: evidence for a phenotype. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 56, M146–157.CrossRefGoogle ScholarPubMed
Hogan, D. B., MacKnight, C. and Bergman, H. (2003). Models, definitions, and criteria of frailty. Aging Clinical and Experimental Research, 15, 1.Google ScholarPubMed
Jacobs, J. M., Cohen, A., Ein-Mor, E., Maaravi, Y. and Stessman, J. (2011). Frailty, cognitive impairment and mortality among the oldest old. Journal of Nutrition, Health and Aging, 15, 678–682.CrossRefGoogle ScholarPubMed
Jacqmin-Gadda, H., Fabrigoule, C., Commenges, D., Letenneur, L. and Dartigues, J.-F. (2000). A cognitive screening battery for dementia in the elderly. Journal of Clinical Epidemiology, 53, 980–987.CrossRefGoogle ScholarPubMed
Kanapuru, B. and Ershler, W. B. (2009). Inflammation, coagulation, and the pathway to frailty. American Journal of Medicine, 122, 605–613.CrossRefGoogle ScholarPubMed
Katz, S., Downs, T. D., Cash, H. R. and Grotz, R. C. (1970). Progress in development of the index of ADL. Gerontologist, 10, 20–30.CrossRefGoogle ScholarPubMed
Korean Statistical Information Service. (2012). Population Projections and Summary Indicators for Korea. Available at: http://kosis.kr/eng/search/search_001000.jsp; last accessed 17 May 2013.Google Scholar
Langlois, F., Vu, T. T. M., Kergoat, M.-J., Chassé, K., Dupuis, G. and Bherer, L. (2012). The multiple dimensions of frailty: physical capacity, cognition, and quality of life. International Psychogeriatrics, 24, 1429.CrossRefGoogle ScholarPubMed
Lawton, M. P. (1969). Supportive services in the context of the housing environment. Gerontologist, 9, 15–19.CrossRefGoogle ScholarPubMed
Lee, D. Y.et al. (2002). A normative study of the Mini-Mental State Examination in the Korean elderly. Journal of the Korean Neuropsychiatric Association, 41, 508–525.Google Scholar
Macuco, C. R. M.et al. (2012). Mini-Mental State Examination performance in frail, prefrail, and nonfrail community dwelling older adults in Ermelino Matarazzo, São Paulo, Brazil. International Psychogeriatrics, 1, 1–7.Google Scholar
Ministry of Health and Welfare. (2009). 2008 Living Profiles of Older People Survey: A National Report on the Living Status and Welfare Needs of Older Adults. Seoul, South Korea: Ministry of Health and Welfare, Keimyung University Industry-Academic Cooperation Foundation.Google Scholar
Ottenbacher, K. J., Ostir, G. V., Peek, M. K., Snih, S. A., Raji, M. A. and Markides, K. S. (2005). Frailty in older Mexican Americans. Journal of the American Geriatrics Society, 53, 1524–1531.CrossRefGoogle ScholarPubMed
Ottenbacher, K. J.et al. (2009). Mexican Americans and frailty: findings from the Hispanic Established Populations Epidemiologic Studies of the Elderly. American Journal of Public Health, 99, 673–679.CrossRefGoogle ScholarPubMed
Rockwood, K.et al. (2004). Prevalence, attributes, and outcomes of fitness and frailty in community-dwelling older adults: report from the Canadian Study of Health and Aging. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 59, 1310–1317.CrossRefGoogle ScholarPubMed
Rockwood, K.et al. (2005). A global clinical measure of fitness and frailty in elderly people. Canadian Medical Association Journal, 173, 489–495.CrossRefGoogle ScholarPubMed
Samper-Ternent, R., Al Snih, S., Raji, M. A., Markides, K. S. and Ottenbacher, K. J. (2008). Relationship between frailty and cognitive decline in older Mexican Americans. Journal of the American Geriatrics Society, 56, 1845–1852.CrossRefGoogle ScholarPubMed
Small, B. J., Viitanen, M. and Backman, L. (1997). Mini-Mental State Examination item scores as predictors of Alzheimer's disease: incidence data from the Kungsholmen Project, Stockholm. Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 52, M299–304.CrossRefGoogle ScholarPubMed
United Nations. (2009). World Population Ageing 2009. New York, NY: United Nations Department of Economic and Social Affairs. Available at: http://www.un.org/esa/population/publications/WPA2009/WPA2009_WorkingPaper.pdf.Google Scholar
Walston, J.et al. (2006). Research agenda for frailty in older adults: toward a better understanding of physiology and etiology. Summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. Journal of the American Geriatrics Society, 54, 991–1001.CrossRefGoogle Scholar