Relationship Between Frailty and Cognitive Impairment in Elderly
Abstract
Frailty is an important geriatric syndrome, defined as an age related clinical state of increased vulnerability to stress and decreased ability to maintain homeostasis. While physical impairment is the hallmark of frailty, cognitive status and psychological wellbeing might also be taken into account to fully understand the frailty syndrome.
Aim and objective: To assess the relationship between frailty and cognitive decline in elderly.
Materials and methods: A cross sectional ,observational study was conducted among the outpatients attending Geriatric medicine OPD, Madras Medical College, Chennai. Patients selected by inclusion ,exclusion criteria were categorised into frail and non frail based on frailty phenotype test by Fried and others. Fifty frail patients and fifty age, sex, educational status matched non frail controls were selected. They were subjected to Addenbrooke’s Cognitive Examination – Revised (ACE-R), Trail making test A and B, Pattern comparision test and Letter comparison test. Data analysis was done using Binary logistic regression .
Result: It was found that global cognitive function (p= 0.0001), visuospatial orientation (p = 0.038), executive fuction (p = 0.0004) and processing speed (p = 0.00003) were significantly impaired in frail than in non frail patients. Binary Logistic Regression analysis was used for predicting frailty in the study population , after adjusting for all chronic conditions .Global cognitive function, executive function, processing speed were significant predictors of frailty. Hosmer Lemeshow test showed that the model was of good fit (p > 0.05).Mc Fadden R square of 0.423 showed that the model could predict 42.3% variability of frail in the study population.
Conclusion: Frail patients had cognitive decline. Impairment of cognition could also predict frailty.
Keywords: Frailty, Addenbrookes Cognitive Examination – Revised (ACE-R), Trail making test A and B, Pattern comparison test ,Letter comparison test.
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