Cognitive frailty is a robust predictor of falls, injuries, and disability among community-dwelling older adults

Abstract

Background Cognitive frailty, a combination of physical frailty and cognitive impairment, is associated with functional decline in older adults. However, there is limited information if cognitive frailty predicts the incidence of falls, injuries, and disability. In this study, we aimed to determine the ability of cognitive frailty in predicting the incidence of falls, injuries and disability among multi-ethnic older adults in Malaysia at 5 years follow-up. Methods In this prospective cohort study, a total of 400 participants aged 60 years and above were successfully followed up at 5 years. Participants’ socio-demographic, medical history, psycho-social, physical, cognitive and dietary intake information was obtained. Cognitive frailty was defined as comorbid physical frailty (> 1 Fried criteria) and mild cognitive impairment (Petersen criteria). Univariate analysis was performed for all variables, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls, injuries, and disability. The significant value was set at p < 0.05. Results Cognitive frailty was found to be associated with greater risk of adverse consequences after adjusting for covariates. Both cognitive frailty (Adjusted Odd ratio (Adj OR) = 2.98, 95% confidence interval (CI): 1.78–4.99, p < 0.05) and physical frailty (Adj OR = 2.88, 95% CI: 1.19–6.99, p < 0.05) were significant predictors of incidence of falls. Risk of injuries was also significantly increased with the presence of cognitive frailty (Adj OR = 3.06, 95% CI: 1.23–7.60, p < 0.05) and physical frailty (Adj OR = 3.04, 95% CI: 1.75–5.28, p < 0.05). In addition, cognitive frailty (Adj OR = 5.17, 95% CI: 1.11–24.21, p < 0.05) and physical frailty (Adj OR = 4.99, 95% CI: 1.11–22.57, p < 0.05) were shown to significantly predict the incidence of disability among older adults. Conclusion Cognitive frailty is a robust predictor of falls, injuries, and disability in older adults. Possible early multi-domain preventive and management strategies of cognitive frailty that contribute to adverse consequences are required to decrease further functional decline and promote independence in older adults.

Global Research on Cognitive Frailty: A Bibliometric and Visual Analysis of Papers Published during 2013–2021

“…The results of this study indicate, to a certain extent, that health care practitioners and researchers from China have begun to focus on cognitive frailty research. Cognitive frailty could increase the risk of adverse health outcomes among older people, such as dementia, falls, disability, and mortality [10,[12][13][14][15][16], which may further increase the health care expenditure of the sufferers and threaten their quality of life. As China has the world's largest population of older people, Chinese scholars have suggested continuing to focus on cognitive frailty research for the next few years, especially in collaboration with productive institutions from the aforementioned countries.…”

“…Evidence showed that a variety of socio-demographic factors and health conditions can increase the risk of cognitive frailty, such as advanced age, low schooling, comorbidity, malnutrition, low social participation, sedentary lifestyle, and insomnia [10,11]. Moreover, many studies have revealed that cognitive frailty can significantly increase the risk of dementia, mortality [10,12,13], falls [14,15], and disability [16] in older adults.…”

Global Research On Cognitive Frailty: A Bibliometric and Visual Analysis of Papers Published During 2013 – 2021

“…Results in this study to a certain extent indicated that health care practitioners and researchers in China has begun to focus on cognitive frailty research. Previous studies have reported that cognitive frailty could increase the risk of adverse health outcomes (e.g., dementia, falls, disability, and mortality) among older people [8, [10][11][12][13][14], which may further increase the health care expenditure and threaten their quality of life. Faced with the largest number of older people worldwide, Chinese scholars are suggested to continue to pay attention to cognitive frailty research in the next few years, especially in collaboration with the productive institutions from the above-mentioned developed countries.…”

“…Document co-citation analysis and keyword co-occurrence analysis were conducted to reveal the structure and hotspots within the knowledge domain of cognitive frailty. As indicated, the predictive value of cognitive frailty on health-related outcomes is one popular topic [11,14,25,[33][34][35][36][37]. Apart from the risk of dementia, mortality, and disability, some studies focused on surgical patients and had examined the predictive effect of combined preoperative assessment of frailty and cognitive function for postoperative complications (e.g., delirium, long hospital stay) [34,35].…”

“…Evidence showed that a variety of socio-demographic factors and health conditions can increase the risk of cognitive frailty, such as advanced age, low schooling, comorbidity, malnutrition, low social participation, sedentary lifestyle, and insomnia [8,9]. Moreover, many studies revealed that cognitive frailty can signi cantly increase the risk of dementia, mortality [8, 10,11], falls [12,13], and disability [14].…”