期刊
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
卷 18, 期 3, 页码 252-258出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2016.09.015
关键词
Frailty; cognitive impairment; mortality; functional disability; hospitalization quality of life
资金
- Biomedical Research Council, Agency for Science, Technology and Research in Singapore [03/1/21/17/214, 08/1/21/19/567]
Objectives: There is a recent consensus proposal of cognitive frailty defined by the presence of both physical frailty and cognitive impairment in the absence of dementia. The relevance, validity, and utilization of cognitive frailty, however, is presently unclear. We determine whether concurrent physical frailty and cognitive impairment, compared with physical frailty alone substantially increased adverse health outcomes (functional disability, hospitalization, poor quality of life [QOL], and mortality). Design: Longitudinal study. Setting: Population-based cohort (Singapore Longitudinal Ageing Study, SLAS). Participants: Two thousand three hundred seventy-five Chinese Singaporeans aged 55 and above without dementia and degenerative disorders. Measurements: The associations of physical frailty (Cardio vascular Health Study criteria: 0 = robust, 1-2 = prefrail, 3-5 = frail) with and without cognitive impairment (mini-mental state examination < 26) and adverse outcomes were estimated, controlling for age, gender, education, comorbidity, smoking, alcohol consumption, depressive symptoms, baseline activities of daily living-instrumental and basic activities of daily living disability or QOL score. Results: Compared to robust noncognitively impaired individuals, physical pre-frailty with cognitive impairment was associated with a twofold increased prevalence and incidence of functional disability, a twofold increased incidence of poor QOL, and 1.8-fold increased mortality risks. Cognitively impaired frail individuals stood out with 12- to 13-fold increased prevalence and incidence of functional disability, a five-and 27-fold increased prevalence and incidence of low QOL, and a fivefold increased mortality risk. The estimated prevalence of physical frailty with cognitive impairment was 1.8%, and physical pre-frailty with cognitive impairment was 8.9%. Conclusion: Pre-frailty and frailty with impaired cognitive function, found in 10.7% of this dementia-free population, was associated with an evidently high risk of adverse health outcomes. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY-NC-ND license.
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