The prevalence of cognitive frailty and pre-frailty among older people in Bangkok metropolitan area: a multicenter study of hospital-based outpatient clinics

Abstract

Objectives: To identify the prevalence of, and factors associated with, cognitive frailty and prefrailty, and to investigate correlation between frailty tools. Methods: One hundred and ninety five older adults were recruited from the medical outpatient clinics of 3 tertiary hospitals in Bangkok metropolitan region. The data collected were demographic information, lifestyle factors, functional status, mood assessment, and cognitive and frailty assessments. The frailty tools used were Frailty Phenotype and FRAIL scale. Results: The prevalence of pre-frailty, frailty, mild cognitive impairment (MCI), cognitive pre-frailty and cognitive frailty was 57.4%, 15.9%, 26.2%, 14.4% and 6.7%, respectively. A multivariate analysis showed that age ≥70 years (OR 5.34; 95% CI 2.06-12.63), and education at primary school or under (OR 4.18; 95% CI 1.61-10.82) were associated with cognitive frailty and cognitive pre-frailty. The correlation between physical frailty rated by the Modified Fried Frailty Phenotype and the FRAIL scale was good (Kappa coefficient = 0.741). Conclusions: The prevalence of cognitive frailty is not uncommon which requires screening and interventions. Age and a low educational level were related to cognitive frailty/prefrailty. The FRAIL scale yielded a high correlation with Frailty phenotypes, implying its benefit in routine clinical use in primary care practice, where there is limited time and resources.

Cognitive Frailty: An Update

“…It has been possible to verify some important advances in research on cognitive frailty in the scientific literature. Links between cognitive frailty and years of education continue to highlight the relationships between low wealth, low educational attainment and negative health events (Gallucci et al, 2020 ; Ruan et al, 2020 ; Wongtrakulruang et al, 2020 ), and the mediational role of active engagement in the relationship between cognitive frailty and falls (Zhao et al, 2020 ) appears as an emerging research topic. It is desirable that research on cognitive frailty progressively incorporates other relevant proxies of cognitive reserve, such as leisure activity and work complexity, as well as global measures of the cognitive reserve construct.…”

“…Similarly, Gallucci et al ( 2020 ) reported that education seems to be a protective factor in the incidence of frailty, with more years of education associated with robust or pre-frailty and low education associated with frailty. Wongtrakulruang et al ( 2020 ) associated low education level (primary school or less) a with higher risk of MCI and PF/pre-frailty.…”

An update on cognitive frailty: Its definition, impact, associated factors and underlying mechanisms, and interventions

“…Among sociodemographic factors, older age has been reported to be consistently associated with a higher prevalence of cognitive frailty regardless of the varied operational definitions. 13,18,23,25,35,46,50,52,71,74 Regarding sex, several studies investigating associated factors of cognitive frailty have demonstrated that women were more likely to be diagnosed with cognitive frailty defined by the varied definitions. 35,46,50,74,76 Although, multivariate analysis of most of these studies did not show the independent association of sex with cognitive frailty.…”

Frailty and Its Associated Risk Factors: First Phase Analysis of Multicentre Indonesia Longitudinal Aging Study

“…The prevalence of frailty in Indonesian in 2020 is similar to the prevalence of frailty in East Coast of Peninsular Malaysia based on Fried's phenotype of frailty (18.30%) ( 14 ). The prevalence of frailty was 15.9% in Bangkok metropolitan area ( 15 ), and 13.9% in Northern Thailand ( 16 ). On the other hand, the prevalence of frailty in urban district setting in Malaysia was only 5.7% ( 17 ).…”