Cognitive Frailty and 30-Day Mortality in a National Cohort of Older Chinese Inpatients.

Abstract

PurposeStudies exploring the association of cognitive frailty and mortality have been mainly based on community settings or nursing home settings. The aim of our study was to explore the association between cognitive frailty and 30-day mortality among older Chinese inpatients.Patients and MethodsA national cohort study was performed in different hospitals in China. A baseline survey was conducted from October 2018 and February 2019. Trained investigators collected the 30-day mortality. Cognitive impairment and frailty were defined by the Mini-Cog and FRAIL scale, respectively. Multivariate regression was used to explore the association between cognitive impairment and frailty status with 30-day mortality.ResultsOf these participants, there were 3891 (41.91%) women and 5392 (58.09%) men, with an average age of 72.41 (SD=5.72). The prevalence of cognitive frailty was 5.44%. After adjusting for age, gender, education, depression and activities of daily living (ADL), the odds ratios (ORs) for 30-day mortality among inpatients were 3.43 (95% CI: 1.80–6.55) for cognitive frailty, 1.85 (95% CI: 1.01–3.41) for frailty only, and 1.43 (95% CI: 0.77–2.65) for cognitive impairment only compared to the reference group (neither frailty nor cognitive impairment). In addition, the discrimination of 30-day mortality was higher among patients with cognitive frailty (area under the curve =0.676 [95% CI: 0.621–0.731]) than either frailty (area under the curve =0.644 [95% CI: 0.594–0.694]) or cognitive impairment (area under the curve = 0.606 [95% CI: 0.556–0.655]) separately. Stratified analysis showed that these associations still existed when grouped by gender.ConclusionOur study found that Chinese inpatients with cognitive frailty had a higher risk of 30-day mortality than those without frailty and cognitive impairment, suggesting that clinicians should be encouraged to perform early screening of patients with frailty and cognitive impairment and carry out effective interventions to reverse cognitive frailty syndrome.