Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea.
Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea.
Sci Rep. 2021 May 20;11(1):10658. doi: 10.1038/s41598-021-90125-6.
Frailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008-2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the "frail → frail" group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.
衰弱被认为是一种多维老年综合征,表现为与年龄相关的多种缺陷的积累。衰弱转变的后果仍在研究之中。本研究评估了衰弱转变对老年人群认知功能的影响。我们使用了源自韩国老龄化纵向研究(KLoSA)(2008-2018 年)的数据,该研究对象为年龄在 65 岁及以上的老年人。使用经过验证的韩国衰弱量表(称为衰弱量表(FI))评估衰弱,使用韩国版简易精神状态检查(K-MMSE)测量认知功能。使用滞后广义估计方程(GEE)、t 检验和 ANOVA 来研究衰弱的转变及其与认知功能的关系。经历衰弱转变(衰弱改善)、发展为衰弱和衰弱保持不变的受访者,其认知功能比持续非衰弱的受访者更有可能较低。年龄较大、日常生活活动(ADL)障碍和工具性 ADL 障碍与认知功能下降的相关性更负,尤其是在“衰弱→衰弱”组。衰弱量表所有单个组成部分的变化均与认知功能障碍显著相关。结果表明衰弱转变与认知障碍之间存在关联。在 2 年的时间里,剩余的虚弱男性认知下降率最高,而女性从不虚弱状态转变为虚弱状态与认知功能的最低值显著相关。我们建议对老年人进行早期干预和预防策略,以帮助改善或减缓衰弱和认知功能下降。