Cognitive Frailty And Its Association With Disability Among Community-Dwelling Older Adults In Urban Areas Of China

Objectives:As an important geriatric syndrome,cognitive frailty has negative impact on physical health and functional status in older adults.The purposes of this study were to rate the prevalence of cognitive frailty and explore the relationships between cognitive frailty,as well as its six components,and prevalent IADL disability among community-dwelling older adults in China.Methods:This study was a cross-sectional study.From September 2018 to May 2019,convenient sampling was adopted to recruited community-dwelling older adults from eight community health centers in Wuhan,central China.The baseline data regarding socio-demographic characteristics,physical health,and lifestyles was collected using a self-designed questionnaire.Other instruments include Geriatric Depression Scale(GDS-30),Lawton and Brody Instrumental Activities of Daily Living Scale(IADL),Mini-mental State Examination(MMSE),and Fried’s Frailty Phenotype.The IBM SPSS Statistics,version 21.0,software was used to perform the statistical analysis.The relationships between cognitive frailty,as well as its components,and IADL disability was identified constructing binary logistic regression analysis.The level of significance was set at P<0.05 in all analyses.Results:A total of 313 community-dwelling older adults aged between 65 and 94 years old were included in this study.78.9% of participants were female.About 47.3% of participants resulted pre-frail,and 27.1% frail.The median and quartile range(QR)of MMSE score were 25.00 and 6.00,respectively,and 22.7% of subjects had cognitive impairment.The prevalence of cognitive frailty and IADL disability was 8.9% and42.2%,respectively.Compared with those without cognitive frailty,participants with cognitive frailty were older,less educated,more likely to be single,less likely to have regularexercises,with worse cognitive performance and functional status,and had more depressive symptoms.The results of binary logistic regression analysis showed significant relationships between IADL functioning and cognitive frailty.Compared with those who are robust and cognitively normal,frail older adults with cognitive impairment were significantly more likely to report IADL disability(OR=29.57;95%CI=2.568～340.508).As for subdimensions of cognitive frailty,cognitive impairment(OR=7.951;95% CI=3.677～17.195),self-reported exhaustion(OR=3.684;95%CI=1.858～7.303),weakness(OR=2.521;95% CI=1.279～4.967),and low physical activity(OR=3.887;95% CI=1.825～8.281)components were independently associated with IADL limitations after adjusted for covariables.However,unintentional weight loss and slowness were not significantly associated with higher risks of prevalent IADL disability among community-dwelling older adults in China.Conclusion:The overall prevalence of cognitive frailty was 8.9%.Cognitive frailty was significantly associated with higher risks of prevalent IADL disability.As for subdimensions of cognitive frailty,cognitive impairment,self-reported exhaustion,weakness,and low physical activity components were independently associated with higher risks of IADL limitations.In addition,unintentional weight loss and slowness were not significantly associated with IADL disability among community-dwelling older adults in China.These results can provide a basis for future health management and health guidance of daily functioning in community-dwelling older adults.