Effects of reversible cognitive frailty on disability, quality of life, depression, and hospitalization: a prospective cohort study

Abstract

Objectives

Cognitive frailty, a potentially reversible condition describing the concurrence of physical frailty and mild cognitive impairment (MCI), has been recently proposed to incorporate subjective cognitive decline (SCD), a reversible pre-MCI state with more readily available cognitive reserve, as well as pre-physical frailty. Reversible cognitive frailty has been associated with dementia and mortality. We aimed to examine the association of reversible cognitive frailty with other adverse outcomes including disability, poor quality of life (QOL), depression, and hospitalization.

Methods

This was a cohort study with 1-year follow-up among 735 Chinese community-dwelling older adults with intact cognition. Reversible cognitive frailty was operationalized with the presence of pre-physical or physical frailty identified by the Frailty Phenotype and SCD identified by the simplified SCD questionnaire including four self-report cognitive domains of memory, naming, orientation, and mathematical reasoning. Adverse outcomes included incident Activities of Daily Living (ADL)-Instrumental ADL (IADL) disability, poor physical, mental and overall QOL, depression, and hospitalization over 1-year follow-up.

Results

The prevalence of reversible cognitive frailty was 27.8%. Participants with reversible cognitive frailty had higher risk of the incidence of ADL-IADL disability, poor physical QOL, poor mental QOL, poor overall QOL, and depression (Odds Ratios: 1.67–4.38, P < 0.05), but not higher risk of hospitalization over 1-year follow-up.

Conclusion

Reversible cognitive frailty was not uncommon and associated with incident disability, poor QOL, and depression among community-dwelling older adults. Early identification of reversible cognitive frailty can facilitate targeted interventions and may promote independence in older adults.

Supplemental data for this article is available online at http://dx.doi.org/10.1080/13607863.2021.2011835

Keywords:

• Reversible cognitive frailty
• disability
• depression
• quality of life
• hospitalization

Acknowledgment

We are most grateful to all the participants and community-dwelling staffs for their patience and cooperation.

Disclosure statement

The authors declare no conflicts of interest.

Ethics approval

The study was reviewed and approved by the Institutional Review Board of Shandong University, Jinan, China.

Authors’ contributions

Wenyu Wang and Huaxin Si contributed equally to this work.

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Wenyu Wang, Huaxin Si, Ruby Yu, Yaru Jin, Xiaoxia Qiao, Qinqin Liu, Yanhui Bian, Jiaqi Yu, Lili Ji, Cuili Wang. The first draft of the manuscript was written by Wenyu Wang, Huaxin Si, Ruby Yu, Cuili Wang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. All authors agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Additional information

Funding

This work was supported by the National Natural Science Foundation of China (NSFC: 71673168). The funders had no role in the design, data collection, analysis or preparation of the manuscript.