Abstract
BackgroundLittle is known about the heterogeneous clinical profile of physical frailty and its association with cognitive impairment in older U.S. nursing home (NH) residents.MethodsMinimum Data Set 3.0 at admission was used to identify older adults newly-admitted to nursing homes with life expectancy ≥6 months and length of stay ≥100 days (n = 871,801). Latent class analysis was used to identify physical frailty subgroups, using FRAIL-NH items as indicators. The association between the identified physical frailty subgroups and cognitive impairment (measured by Brief Interview for Mental Status/Cognitive Performance Scale: none/mild; moderate; severe), adjusting for demographic and clinical characteristics, was estimated by multinomial logistic regression and presented in adjusted odds ratios (aOR) and 95% confidence intervals (CIs).ResultsIn older nursing home residents at admission, three physical frailty subgroups were identified: “mild physical frailty” (prevalence: 7.6%), “moderate physical frailty” (44.5%) and “severe physical frailty” (47.9%). Those in “moderate physical frailty” or “severe physical frailty” had high probabilities of needing assistance in transferring between locations and inability to walk in a room. Residents in “severe physical frailty” also had greater probability of bowel incontinence. Compared to those with none/mild cognitive impairment, older residents with moderate or severe impairment had slightly higher odds of belonging to “moderate physical frailty” [aOR (95%CI)moderate cognitive impairment: 1.01 (0.99–1.03); aOR (95%CI)severe cognitive impairment: 1.03 (1.01–1.05)] and much higher odds to the “severe physical frailty” subgroup [aOR (95%CI)moderate cognitive impairment: 2.41 (2.35–2.47); aOR (95%CI)severe cognitive impairment: 5.74 (5.58–5.90)].ConclusionsFindings indicate the heterogeneous presentations of physical frailty in older nursing home residents and additional evidence on the interrelationship between physical frailty and cognitive impairment.
Highlights
Over 1.2 million U.S older adults aged ≥65 years reside in a nursing home (NH) [1]
Older residents who were racial/ethnic minorities were less likely to belong to the “moderate physical frailty” subgroup, but more likely to belong to the “severe physical frailty” subgroup
Arthritis or osteoporosis were more likely to belong to the “moderate physical frailty” subgroup, but less likely to be in the “severe physical frailty” subgroup
Summary
Physical frailty, characterized by decreased physiologic reserve and increased vulnerability to exogenous stressors [2], and cognitive impairment, ranging from mild cognitive impairment to fully-developed dementia [3], are the two most prominent conditions in this population Both are highly prevalent, with 30–85% of older nursing home residents experiencing physical frailty [4,5,6] and 65% moderate to severe cognitive impairment [1]. In a cohort of communitydwelling older adults in Taiwan, three physical frailty subgroups were identified with LCA: one characterized by slowness and weakness, one weight loss and exhaustion, and one low physical activity [10]. Little is known about the heterogeneous clinical profile of physical frailty and its association with cognitive impairment in older U.S nursing home (NH) residents
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
