Associations Between Hearing Impairment and Dysphagia with Cognitive Frailty in Nursing Homes Older Adults

To establish the prevalence of cognitive frailty (CF) among older adults residing in nursing homes and to evaluate the relationship between this condition and the prevalence of hearing impairment and dysphagia.

A cross-sectional study of 451 individuals 60+ years of age living in nursing homes in Chengdu, Sichuan, China. The FRAIL and Chinese Mini Mental Status (CMMS) scales were respectively employed to measure physical frailty (PF) and cognitive functionality, with the results being used to separate subjects into four groups: cognitively intact non-PF individuals ("robust" group), cognitively impaired non-PF individuals ("MCI-only" group), cognitively intact individuals with PF ("PF only" group), and cognitively impaired individuals with PF ("CF" group). Individuals in these groups were evaluated for demographic characteristics, geriatric syndrome, and disease status. Hearing impairment was screened by self-report, and dysphagia was screened using the Eating Assessment Tool (EAT-10). Risk factors were evaluated through a stepwise logistic regression approach.

In total, 451 individuals (144 male, 307 female; mean age: 84.15±5.63 years) were enrolled in this study. CF was found it impact 18.6% of this cohort. Risk factors significantly associated with CF in stepwise logistic regression analyses included hearing impairment (P=0.008, OR=3.936, 95% CI=1.433-10.813) and dysphagia (P=0.046, OR=3.441, 95% CI=1.021-11.601). The CF group also contained a larger proportion of individuals affected by dysphagia and hearing impairment relative to the MCI-only and robust groups, respectively.

CF affects approximately 20% of older adults in nursing home environments, and both hearing impairment and dysphagia are strongly associated with an increased risk of CF.