Which Cognitive Domain Is a Better Predictor of Frailty and Disability in Community-Dwelling Older Patients?

Cognitive function is key to aging and independence. Our aim was to evaluate the associations of domain-specific cognitive performance with disability and frailty. Understanding these associations can improve clinical decision-making and patient outcomes in aging populations.

This retrospective study was conducted at the Geriatric Outpatient Clinic at a tertiary hospital. Domains of the Standardized Mini-Mental State Examination and the clock drawing test were used for cognitive assessment. Clinical frailty scale (CFS), mini nutritional assessment short form (MNA), geriatric depression scale short form (GDS), activities of daily living (ADL), and instrumental activities of daily living (IADL) were used for geriatric assessment.

Of the 274 patients, 65.3% (179) were women, and the mean age of patients was 77.9 (±7.3). While 32.8% of patients were frail according to CFS, 44.9% had IADL disability. The orientation and calculation-attention domains were associated with frailty and IADL disability, regardless of age, sex, education level, number of medications, number of diseases, MNA score, and GDS. On the other hand, the recall and executive function domains were not found to be associated with frailty or IADL disability While language domain was associated with both ADL and IADL scores in linear regression, it was only associated with ADL disability in binary regression analysis in all models.

Routine screening of language, orientation, and calculation-attention domains may help identify older adults at risk for frailty and disability, allowing for timely interventions.