Brian Downer1, Soham Al Snih1,2,3, Bret T Howrey4, Mukaila A Raji2,3, Kyriakos S Markides5, Kenneth J Ottenbacher1,3. 1. a Division of Rehabilitation Sciences, University of Texas Medical Branch , Galveston , TX , USA. 2. b Department of Internal Medicine/Division of Geriatric Medicine, University of Texas Medical Branch , Galveston , TX , USA. 3. c Sealy Center on Aging, University of Texas Medical Branch , Galveston , TX , USA. 4. d Department of Family Medicine, University of Texas Medical Branch , Galveston , TX , USA. 5. e Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston , TX , USA.
Abstract
Objectives: Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans. Methods: Data for this analysis came from the 2006-2007 and 2010-2011 waves of the Hispanic EPESE. The final sample included 639 Mexican Americans aged ≥77 years who were non-frail or pre-frail in 2006-2007. Frailty measure included weight loss, exhaustion, weakness, and slow walking speed. Participants were classified as non-frail (0 criteria) and pre-frail (1 criterion) at baseline. Cognitive impairment was defined as <21 points on the MMSE. At baseline, participants were grouped as: cognitively intact non-frail, cognitively intact pre-frail, cognitively impaired non-frail, and cognitively impaired pre-frail. Logistic and hazard regression models were used to evaluate the odds of being frail in 2010-2011 and risk for 10-year mortality. Results: Cognitively impaired pre-frail participants were more likely to become frail (OR = 4.82, 95% CI = 2.02-11.42) and deceased (HR = 1.99, 95% CI = 1.42-2.78). Cognitively impaired non-frail participants had significantly higher risk for mortality (HR = 1.55, 95% CI = 1.12-2.19) but not frailty (OR = 1.29, 95% CI = 0.50-3.11). Being cognitively intact and pre-frail at baseline was not significantly associated with being frail at follow-up (OR = 1.62, 95% CI = 0.83-3.19) or mortality (HR = 1.29, 95% CI = 0.97-1.71). Conclusions: Comorbid cognitive impairment and pre-frailty is associated with future frailty and mortality in older Mexican Americans. Screening for cognitive impairment may be effective for identifying pre-frail Mexican Americans who are at the highest risk of frailty and mortality.
Objectives:Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans. Methods: Data for this analysis came from the 2006-2007 and 2010-2011 waves of the Hispanic EPESE. The final sample included 639 Mexican Americans aged ≥77 years who were non-frail or pre-frail in 2006-2007. Frailty measure included weight loss, exhaustion, weakness, and slow walking speed. Participants were classified as non-frail (0 criteria) and pre-frail (1 criterion) at baseline. Cognitive impairment was defined as <21 points on the MMSE. At baseline, participants were grouped as: cognitively intact non-frail, cognitively intact pre-frail, cognitively impaired non-frail, and cognitively impaired pre-frail. Logistic and hazard regression models were used to evaluate the odds of being frail in 2010-2011 and risk for 10-year mortality. Results: Cognitively impaired pre-frail participants were more likely to become frail (OR = 4.82, 95% CI = 2.02-11.42) and deceased (HR = 1.99, 95% CI = 1.42-2.78). Cognitively impaired non-frail participants had significantly higher risk for mortality (HR = 1.55, 95% CI = 1.12-2.19) but not frailty (OR = 1.29, 95% CI = 0.50-3.11). Being cognitively intact and pre-frail at baseline was not significantly associated with being frail at follow-up (OR = 1.62, 95% CI = 0.83-3.19) or mortality (HR = 1.29, 95% CI = 0.97-1.71). Conclusions: Comorbid cognitive impairment and pre-frailty is associated with future frailty and mortality in older Mexican Americans. Screening for cognitive impairment may be effective for identifying pre-frail Mexican Americans who are at the highest risk of frailty and mortality.
Entities:
Keywords:
Cognitive functioning; Hispanic aging; functional status
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