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Observational Study
. 2022 Nov 29:17:1697-1706.
doi: 10.2147/CIA.S376691. eCollection 2022.

Coexisting Frailty and Cognitive Impairment as a Predictor of Adverse Outcomes in Older Inpatients After Discharge: Results from a One-Year Follow-Up Study

Xing-Kun Zeng #  1 , Shan-Shan Shen #  1 , Hui-Lan Guan  1 , Ling-Yan Chen  1 , Xu-Jiao Chen  1
Affiliations
Observational Study

Coexisting Frailty and Cognitive Impairment as a Predictor of Adverse Outcomes in Older Inpatients After Discharge: Results from a One-Year Follow-Up Study

Xing-Kun Zeng et al. Clin Interv Aging. .

Abstract

Purpose: This study aimed to investigate the combined effects of frailty and cognitive impairment on adverse outcomes, including new falls and new activities of daily living (ADL) dependency over a 1-year follow-up.

Patients and methods: A total of 311 older hospitalized patients participated in this retrospective observational study and completed a 1-year follow-up. Frailty was assessed by the Clinical Frailty Scale (CFS). Cognitive function was evaluated by the Mini-Mental State Examination (MMSE). All participants were classified into four groups: 1) the healthy group (n=180); 2) the cognitive impairment group only (n=38); 3) the frailty group only (n=44); and 4) coexisting frailty and cognitive impairment group (n=49). The follow-up data of adverse outcomes include the incidences of new falls and new ADL dependence. Binary logistic regression analysis was used to explore the associations of frailty and/or cognitive impairment with adverse outcomes.

Results: The prevalence rates of frailty, cognitive impairment, and co-occurring frailty with cognitive impairment were 29.9%, 28%, and 15.8%, respectively. Among these four groups, there was a statistical difference in the incidence of new ADL dependence during the follow-up period (9.5% vs 11.4% vs 35.9% vs 61.9%, P < 0.001). After adjusting the confounding variables, older hospitalized patients with frailty and cognitive impairment had a higher risk of new ADL dependence when compared with the healthy group (OR: 4.786, 95% CI: 1.492-15.355), but frailty only or cognitive impairment only was not associated with new ADL dependency.

Conclusion: Elderly inpatients with comorbid frailty and cognitive impairment on admission were significantly associated with an increased risk of new ADL dependency 1 year after discharge. Therefore, it is necessary for the early identification of frailty and cognitive impairment, and effective interventions should be implemented.

Keywords: ADL dependency; cognitive impairment; fall; frailty; older adults.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The procedure of patient selection.
Figure 2
Figure 2
Prevalence and trend of coexisting frailty with cognitive impairment, cognitive impairment only, and frailty only by age.
Figure 3
Figure 3
Adverse outcomes of inpatients by the presence of cognitive impairment and/or frailty.
See this image and copyright information in PMC

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