Cognitive Frailty as a Predictor of Mortality in Older Adults: A Longitudinal Study in Peru

Abstract

ObjectiveTo evaluate the role of cognitive frailty and its components as risk factors of mortality in older adults of the Centro Médico Naval (CEMENA) in Callao, Peru during 2010-2015.MethodsWe performed a secondary analysis of data from a prospective cohort that included older adults (60 years and older) treated at the CEMENA Geriatrics service between 2010–2015. Frailty was defined as the presence of three or more criteria of the modified Fried Phenotype. Cognitive impairment was assessed using the Peruvian version of the Mini Mental State Examination (MMSE), considering a score <21 as cognitive impairment. Cognitive frailty was defined as the coexistence of both. In addition, we included sociodemographic characteristics, medical and personal history, as well as the functional evaluation of each participant.ResultsWe included 1,390 older adults (mean follow-up: 2.2 years), with a mean age of 78.5 ± 8.6 years and 59.6% (n = 828) were male. Cognitive frailty was identified in 11.3% (n = 157) and 9.9% (n = 138) died during follow-up. We found that cognitive frailty in older adults (aHR = 3.57; 95%CI: 2.33–5.49), as well as its components, such as sedentary behavior and cognitive impairment (aHR = 7.05; 95%CI: 4.46–11.13), weakness and cognitive impairment (aHR = 6.99; 95%CI: 4.41–11.06), and exhaustion and cognitive impairment (aHR = 4.51; 95%CI: 3.11–6.54) were associated with a higher risk of mortality.ConclusionCognitive frailty and its components were associated with a higher risk of mortality in older adults. It is necessary to develop longitudinal studies with a longer follow-up and that allow evaluating the effect of interventions in this vulnerable group of patients to limit adverse health outcomes, including increased mortality.

Prevalence of cognitive frailty and its associated factors in a population of Iranian older adults

“…A multitude of studies have investigated this topic around the world and the reported prevalence of cognitive frailty varies substantially from 1.6% in South Korea [ 20 ] to 40.0% in Thailand [ 21 ]. The reported prevalence in this study is consistent with the findings from studies conducted in Singapore, South Korea, Peru and Taiwan which reported 10.7%, 11.2%, 11.3% and 15.8%, respectively [ 11 , 15 , 31 , 33 ]. Furthermore, meta-analysis studies have estimated the global pooled prevalence of cognitive frailty to be between 9.0% and 16% [ 34 , 35 ].…”

“…A multitude of studies have demonstrated the detrimental effect of cognitive frailty on adverse health outcomes. Individuals with cognitive frailty are at increased risk of disability, hospitalisation, low quality of life, dementia and mortality [9][10][11][12][13][14][15]. Increased risk of mortality is particularly noteworthy because of its direct and indirect pathways.…”

“…Increased risk of mortality is particularly noteworthy because of its direct and indirect pathways. Cognitive frailty increases the risk of all-cause mortality not only directly [12,14,15], but also indirectly through diminished functional domains and disability [10,11], dementia [13,14] and increased risk of falls and its consequent injuries [16]. Additionally, those with cognitive frailty are more likely to be dependent on long term care, which in turn, can potentially increase the burden of this condition [17].…”

Risk factors and a nomogram for predicting cognitive frailty in Chinese patients with lung cancer receiving drug therapy: A single‐center cross‐sectional study

“…Second, to gain deeper insights into the early prediction of CF risk, both PRCF and RCF were encompassed within the scope of CF assessment. The progression of CF in the elderly leads to functional impairment, hospital readmissions, dementia, and mortality, impacting quality of life and placing burdens on caregivers and the healthcare system 45,46 . Consequently, it assumes paramount importance to construct a predictive model for assessing CF risk and implementing timely interventions.…”

Risk factors and a nomogram for predicting cognitive frailty in Chinese patients with lung cancer receiving drug therapy: a single-center cross-sectional study

“…The advancement of CF precipitates detrimental consequences in the elderly, including functional impairment, hospital readmissions, dementia, and mortality, which not only diminish their quality of life but also impose burdens on both caregivers and the healthcare system [47][48]. Consequently, it assumes paramount importance to construct a predictive model for assessing CF risk and implementing timely interventions.…”