The impact of frailty and cognitive impairment on quality of life: employment and social context matter

Abstract

Background:How cognitive impairment and frailty combine to impact on older adults’ Quality of Life (QoL) is little studied, but their inter-relationships are important given how often they co-occur. We sought to examine how frailty and cognitive impairment, as well as changes in frailty and cognition, are associated with QoL and how these relationships differ based on employment status and social circumstances.Methods:Using the Survey of Health, Ageing, and Retirement in Europe data, we employed moderated regression, followed by simple slopes analysis, to examine how the relationships between levels of health (i.e., of frailty and cognition) and QoL varied as a function of sex, age, education, social vulnerability, and employment status. We used the same analysis to test whether the relationships between changes in health (over two years) and QoL varied based on these same moderators.Results:Worse frailty (b = −1.61, p < .001) and cognitive impairment (b = −0.08, p < .05) were each associated with lower QoL. Increase in frailty (b = −2.17, p < .001) and cognitive impairment (b = −0.25, p < .001) were associated with lower QoL. The strength of these relationships varied depending on interactions with age, sex, education, social vulnerability, and employment status. Higher social vulnerability was consistently associated with lower QoL in analyses examining both static health (b = −3.16, p < .001) and change in health (b = −0.66, p < .001).Conclusions:Many predictors of QoL are modifiable, providing potential targets to improve older adults’ QoL. Even so, the relationships between health, cognition, and social circumstances that shape QoL in older adults are complex, highlighting the importance for individualized interventions.

Factors Associated with Health-Related Quality of Life in Community-Dwelling Older Adults: A Multinomial Logistic Analysis

“…The odds of a very low physical quality of life were 37 times greater among frail older persons than among those who were robust, while the MCS reflected 20 times greater odds of their presenting a poor mental quality of life. Previous studies, too, have reported this association [18,19,20,21,49], which was reinforced in a recent systematic review and meta-analysis that described it as clear and often substantial [22]. Although the growing numbers of frail older people pose a real challenge to health systems around the world, this state of pre-discapacity can in fact be prevented and treated.…”

“…It is important to recall that the benefits of medication should always outweigh the potential harm, and therefore individual circumstances should be taken into account. In recent studies, frailty, too, has been highlighted as a possible determinant of worsened quality of life [18,19,20,21,22]. Frailty is defined as an abnormal health state characterised by the loss of biological reserves, related to the aging process [23].…”

Long-Term Care Admissions Following Hospitalization: The Role of Social Vulnerability

“…The initial logistic regression included all variables (i.e., age, sex, social vulnerability, baseline frailty, and admission frailty) and three interaction terms: sex by social vulnerability, frailty by social vulnerability, and age by social vulnerability. The FI and SVI were multiplied by 10 prior to inclusion in the regression so that coefficients and odds ratios could be interpreted in terms of a 0.1 change in the indices [21,22].…”

Frailty and mental health: association with cognition, sleep, and well-being in older adults

“…Finally Godin et al (2019) studied how cognitive impairment and frailty combine to impact older adults' Quality of Life (QoL). Using the data from the Survey of Health, Ageing, and Retirement in Europe, these investigators employed moderated regression, followed by simple slopes analysis.…”