Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans

Abstract

Objectives: Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans.

Methods: Data for this analysis came from the 2006–2007 and 2010–2011 waves of the Hispanic EPESE. The final sample included 639 Mexican Americans aged ≥77 years who were non-frail or pre-frail in 2006–2007. Frailty measure included weight loss, exhaustion, weakness, and slow walking speed. Participants were classified as non-frail (0 criteria) and pre-frail (1 criterion) at baseline. Cognitive impairment was defined as <21 points on the MMSE. At baseline, participants were grouped as: cognitively intact non-frail, cognitively intact pre-frail, cognitively impaired non-frail, and cognitively impaired pre-frail. Logistic and hazard regression models were used to evaluate the odds of being frail in 2010–2011 and risk for 10-year mortality.

Results: Cognitively impaired pre-frail participants were more likely to become frail (OR = 4.82, 95% CI = 2.02–11.42) and deceased (HR = 1.99, 95% CI = 1.42–2.78). Cognitively impaired non-frail participants had significantly higher risk for mortality (HR = 1.55, 95% CI = 1.12–2.19) but not frailty (OR = 1.29, 95% CI = 0.50–3.11). Being cognitively intact and pre-frail at baseline was not significantly associated with being frail at follow-up (OR = 1.62, 95% CI = 0.83–3.19) or mortality (HR = 1.29, 95% CI = 0.97–1.71).

Conclusions: Comorbid cognitive impairment and pre-frailty is associated with future frailty and mortality in older Mexican Americans. Screening for cognitive impairment may be effective for identifying pre-frail Mexican Americans who are at the highest risk of frailty and mortality.

Keywords:

• Cognitive functioning
• functional status
• Hispanic aging

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

This work was supported by the National Institutes of Health, National Institute on Aging (grant numbers, R01-AG010939, and P30-AG024832), Institute on Minority Health and Health Disparities (R01-MD010355).