Abstract
BackgroundPhysical frailty, characterized by reduced physiologic complexity and ability to cope with stressors, is closely associated with cognitive impairment, which increases the risk of poor clinical outcomes. To better capture the association between frailty and cognitive impairment, a new construct, cognitive frailty, has been proposed. Cognitive frailty is a clinical condition characterized by the simultaneous presence of physical frailty and cognitive impairment. There is little evidence on the relationship between physical frailty and cognition, as well as cognitive frailty, in Chinese older adults. We aimed to elucidate whether physical frailty is associated with cognitive impairment in an older Chinese population.MethodsData were obtained from the China Comprehensive Geriatric Assessment Study. The sample comprised 3202 community-dwelling adults, aged 60 years and older, from seven Chinese cities. Physical frailty was assessed using a modified, four-item version of the Fried criteria, according to frailty phenotype. Cognitive function was assessed using the Mini-Mental State Examination (MMSE).ResultsThe prevalence of physical frailty, prefrailty, cognitive impairment, and cognitive frailty was 9.9, 33.9, 7.5, and 2.3%, respectively (weighted: 8.8, 33.8, 6.5, and 2.0%). The prevalence of the combination of prefrail/frail and cognitive impairment was 5.1% (weighted 4.5%). Frail participants performed worse on global cognition and all cognitive domains than robust and prefrail participants. The MMSE total score was positively correlated with walking speed and negatively correlated with age and frailty. A multivariate logistic regression revealed that after adjusting for age, gender, education level, living area, and chronic diseases, frailty, exhaustion, slowness, and inactivity were significantly associated with poor global cognition.ConclusionsThe standard prevalence of physical frailty, prefrailty, cognitive impairment, and cognitive frailty in community-dwelling older adults in China was 8.8, 33.8, 6.5, and 2.0%, respectively. Frailty, exhaustion, slowness, and inactivity were significantly associated with poor global cognition.
Highlights
Physical frailty, characterized by reduced physiologic complexity and ability to cope with stressors, is closely associated with cognitive impairment, which increases the risk of poor clinical outcomes
Declined cognitive reserve leads to mild cognitive impairment (MCI) and dementia, which runs parallel to the course of physical frailty
We previously reported a 3.3% prevalence of cognitive frailty” (CF) in mainland China with the definition of CF defined by frailty index and the Mini-Mental State Examination (MMSE) and identified its related factors [16]; whether physical frailty was associated with worse cognition is still unknown
Summary
Physical frailty, characterized by reduced physiologic complexity and ability to cope with stressors, is closely associated with cognitive impairment, which increases the risk of poor clinical outcomes. Frailty is a medical syndrome characterized by diminished physical function and reduced age-related physiologic reserve leading to decreased resistance to stressors and increased vulnerability to disability, morbidity, and mortality [1, 2]. Ma et al BMC Geriatrics (2019) 19:53 close association of frailty and cognitive impairment (CI) increases the risk of mortality in later life. Declined cognitive reserve leads to mild cognitive impairment (MCI) and dementia, which runs parallel to the course of physical frailty. As early detection and intervention development to prevent poor clinical outcomes are becoming increasingly important, taking cognition into account may allow for better prediction of adverse outcomes of frailty in later life
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