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Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
Frailty, cognitive impairment and mortality among the oldest old
J M Jacobs1, A Cohen, E Ein-Mor
1Department of Geriatrics and Rehabilitation, Hadassah Hebrew-University Medical Center, Mt. Scopus, Jerusalem 91240, Israel. jacobsj@hadassah.org.il
The Journal of Nutrition, Health & Aging
|October 5, 2011
Summary
Frailty significantly predicts mortality in the oldest old, independent of cognitive impairment. This study highlights frailty as a key risk factor for adverse outcomes in aging populations.
Area of Science:
- Gerontology
- Clinical Medicine
- Public Health
Background:
- Frailty and cognitive impairment are common in aging populations.
- The relationship between frailty and cognitive impairment in the oldest old is not well understood.
- This study investigates the link between frailty, cognitive status, and mortality in individuals aged 85 and older.
Purpose of the Study:
- To examine the association between frailty status and cognitive impairment at age 85.
- To determine the impact of frailty and cognitive impairment on 5-year mortality.
- To identify frailty as an independent predictor of mortality in the oldest old.
Main Methods:
- A cohort of 840 community-dwelling individuals aged 85 from the Jerusalem Longitudinal Cohort Study was assessed.
- Frailty was defined using the Fried phenotype criteria (weight loss, slowness, weakness, exhaustion, low physical activity).
- Cognitive function was evaluated using the Mini Mental State Examination (MMSE), with impairment defined as MMSE score ≤24. Mortality data was collected over a 5-year period.
Main Results:
- 19.5% of participants were frail, 56% were pre-frail, and 24.5% were not frail.
- Prevalence of cognitive impairment (MMSE≤24) was 53.3% in frail individuals, significantly higher than in pre-frail (15%) and non-frail (7.4%) groups.
- Frailty was strongly associated with cognitive impairment (OR 3.77). Five-year mortality was 44.5% for frail, 20.4% for pre-frail, and 13.6% for non-frail individuals.
- After adjusting for covariates, frailty (HR 3.861) remained a significant predictor of 5-year mortality, while cognitive impairment (MMSE≤24) did not (HR 1.25).
Conclusions:
- Frailty status is significantly associated with cognitive impairment in the oldest old.
- Frailty is an independent predictor of subsequent 5-year mortality in this age group.
- These findings underscore the importance of addressing frailty in geriatric care to improve survival.
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