Han Eun Sook, Lee Yunhwan, Kim Jinhee
Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Republic of Korea.
Int Psychogeriatr. 2014 Jan;26(1):155-63. doi: 10.1017/S1041610213001841. Epub 2013 Oct 23.
Frailty is highly prevalent in older people, but its association with cognitive function is poorly understood. The aim of this study was to examine the association between cognitive function and frailty in community-dwelling older adults.
Data were from the 2008 Living Profiles of Older People Survey, comprising 10,388 nationally representative sample aged 65 years and older living in the community in South Korea. Frailty criteria included unintentional weight loss, exhaustion, weakness, low physical activity, and slow walking speed. Cognitive function was assessed using the Korean version of the Mini-Mental State Examination. Multinomial logistic regression models were constructed with frailty status regressed on cognitive impairment and subdomains of cognitive function, adjusting for covariates.
Those who were frail showed a higher percentage of cognitive impairment (55.8% in men, 35.2% in women) than those who were not (22.1% in men, 15.6% in women). Cognitive impairment was associated with an increased risk of frailty in men (odds ratio (OR) = 1.81, 95% confidence interval (CI): 1.25-2.60) and women (OR = 1.69, 95% CI: 1.25-2.30) even after controlling for all covariates. Among the subdomains of cognitive function, time orientation, registration, attention, and judgment were associated with a lower likelihood of frailty in both men and women after adjusting for confounders. Among women higher scores on recall, language components, and visual construction were also significantly associated with lower odds of frailty.
Cognitive impairment was associated with a higher likelihood of frailty in community-dwelling older men and women. Total scores and specific subdomains of cognitive function were inversely associated with frailty.
衰弱在老年人中非常普遍,但其与认知功能的关联尚不清楚。本研究的目的是探讨社区居住的老年人认知功能与衰弱之间的关联。
数据来自2008年老年人生活状况调查,包括10388名年龄在65岁及以上、居住在韩国社区的具有全国代表性的样本。衰弱标准包括非故意体重减轻、疲惫、虚弱、低体力活动和行走速度缓慢。认知功能采用韩国版简易精神状态检查表进行评估。构建多项逻辑回归模型,将衰弱状态回归到认知障碍和认知功能子领域,并对协变量进行调整。
与非衰弱者相比,衰弱者的认知障碍百分比更高(男性为55.8%,女性为35.2%,而非衰弱者男性为22.1%,女性为15.6%)。即使在控制所有协变量后,认知障碍与男性(优势比(OR)=1.81,95%置信区间(CI):1.25 - 2.60)和女性(OR = 1.69,95% CI:1.25 - 2.30)的衰弱风险增加相关。在认知功能子领域中,经过混杂因素调整后,时间定向、记忆、注意力和判断力与男性和女性的衰弱可能性较低相关。在女性中,回忆、语言成分和视觉构建方面的较高得分也与较低的衰弱几率显著相关。
认知障碍与社区居住的老年男性和女性的衰弱可能性较高相关。认知功能的总分和特定子领域与衰弱呈负相关。