Specific cognitive domains and frailty trajectories among older Taiwanese adults

Abstract

Objective: To investigate the associations of specific cognitive functions and with the frailty trajectory among older Taiwanese adults.

Methods: At baseline, 730 community-dwelling older adults were recruited from outpatient clinics of a general hospital. Frailty status was defined using phenotype criteria. Global cognition was assessed using the modified Telephone Interview of Cognitive Status and Mini-Mental State Examination (MMSE). The Mattis Dementia Rating Scale (MDRS) and Digit Symbol Substitution Test were used to evaluate 6 cognitive domains: attention, initiation/perseveration, construction, conceptualization, memory, and processing speed. The group-based trajectory model was used to identify latent frailty trajectory groups and the multinomial logistic regression was to examine the relationships of specific cognitive functions with frailty trajectory.

Results: Among 485 participants (168 men, 317 women, and mean age: 71.1 ± 5.5 years) completed 2 annual follow-up assessments, three frailty trajectory groups of improvement, no-change, and progression were identified. After adjusting for baseline frailty status, age, sex, global cognition, regular exercise habit, and number of comorbidities, higher scores on MDRS’s initiation/perseveration (odds ratio [OR] = 0.85; 95% CI = 0.75-0.95) and attention (OR = 0.63; 95% CI = 0.38-1.00), respectively, were significantly associated with lower risk of frailty progression. Conversely, no significant association was detected between MMSE or TICSM scores and frailty improvement or progression.

Conclusion: Specific cognitive functions of initiation/perseveration and attention, rather than global cognition, may be more useful to predict frailty progression, thus allowing the identification of at-risk older adults.

Keywords:

• cognitive function
• frailty
• latent class analysis
• older adults
• Taiwan

Acknowledgements

This work was supported by the National Health Research Institutes (NHRI-EX111-10804PI), Taiwan, R.O.C.

Disclosure statement

No commercial party having a direct or indirect interest in the subject matter of this research will confer a benefit on the authors or on any organization with which the authors are associated. This material has not previously been presented in any form.

Sponsor’s role

The funding sources did not participate in the planning, collection, analysis, or interpretation of data or in the decision to submit for publication.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [MRL], upon reasonable request.

Authors’ contributions

MRL designed the study. LS, HFH, SJL, and WYY performed literature search, data collection, and analysis. LS wrote the manuscript draft. MRL revised the manuscript. All authors have read and approved the contents of the submitted manuscript.

Additional information

Funding

This work was supported by the National Health Research Institutes (NHRI-EX110-10804PI), Taiwan, R.O.C.