Cognitive Assessment of Older People: Do Sensory Function and Frailty Matter?

Background: To examine the associations of visual and hearing functions, and frailty with subjective memory complaints (SMCs) in a community primary care pilot project of older people aged 60 years and over. Methods: The study was conducted in 24 community centers. A total of 1949 community-dwelling older people aged between 60⁻97 years were evaluated for which detailed information regarding socio-demographics, lifestyle, and clinical factors were documented at baseline and an average of 12 months later. SMCs were assessed using the 5-item Abbreviated Memory Inventory for the Chinese (AMIC). Visual and hearing functions were measured with two separate single questions. Frailty was assessed using a simple frailty question (FRAIL). Results: At baseline, 1685 (74.6%) participants had reported at least 3 SMCs (AMIC score ≥ 3). Of the 573 participants without / with 1⁻2 SMCs (AMIC score = 0⁻2) at baseline, 75 had incomplete data regarding SMCs and 190 developed at least 3 SMCs after 12 months. After adjustments for age, sex, marital status, educational level, hypertension, and diabetes at baseline, poor vision (OR 2.2 95% CI 1.8⁻2.7), poor hearing (OR 2.2 95% CI 1.8⁻2.8), and frailty (OR 4.6 95% CI 3.1⁻6.7) at baseline were each significantly associated with an increased risk of at least 3 SMCs at follow-up. After a further adjustment for baseline SMCs, the associations remained significant. Similar results were obtained when incident SMCs and improvement in subjective memory were used as the outcome variables; and Conclusions: In the care of older people, detection of sensory impairment and frailty through screening may allow formulation of strategies to prevent or delay the onset of cognitive decline.