Xinjuan Wu, Department of Nursing, Chinese Academy of Medical Sciences - Peking Union Medical College, Peking Union Medical College Hospital (Dongdan Campus), Beijing, 100730, China, E-mail:
J Nutr Health Aging. 2021;25(8):993-998. doi: 10.1007/s12603-021-1670-y.
Previous studies have investigated the association between cognitive frailty and falls among older adults in community; however, no study investigated this relationship among older patients living in hospital. This study aimed to examine the relationship of cognitive frailty with falls among older inpatients in Chinese hospital.
This analysis consisted of 9192 older inpatients aged 65 years or over from six hospitals in China. We used FRAIL scale and Mini-Cog to assess frailty and cognitive impairment, respectively. A generalized estimating equation was used to examine the relationship between cognitive frailty and falls at 30-day follow-up.
Among 9192 older inpatients enrolled in this present study, the mean (SD) age was 72.40(5.72) years, with 3850(41.88%) women. The cross-sectional analysis found that after controlling for variables (age, gender, education, depression, and hospital ward cluster effect), hospitalized patients with cognitive frailty, frailty only, or cognitive impairment only at baseline were all associated with history of falls (P<0.05). At 30-day follow-up, generalized estimating equation with full-adjustment showed that inpatients with cognitive frailty were at greater risk of falls than those of non-frail and cognitive intact (OR=3.0,95%CI:1.32-6.83). This association was also observed in individuals with frailty only (OR=2.11,95%CI:1.04-4.27) but not for patients with cognitive impairment only((OR=1.11,95%CI:0.43-2.85).
Our study suggested that hospitalized Chinese older adults with cognitive frailty were independently associated with falls. Early screening frailty and cognitive impairment were significant for older patients by clinicians, and corresponding interventions, exercise training and nutritional programs, should be implemented to prevent falls.
本研究旨在探讨中国医院老年住院患者认知脆弱与跌倒之间的关系。
本分析纳入了来自中国 6 家医院的 9192 名 65 岁及以上的老年住院患者。我们分别使用 FRAIL 量表和 Mini-Cog 评估脆弱性和认知障碍。使用广义估计方程来检验 30 天随访时认知脆弱与跌倒之间的关系。
在本研究纳入的 9192 名老年住院患者中，平均（SD）年龄为 72.40（5.72）岁，其中 3850（41.88%）名女性。横断面分析发现，在控制了变量（年龄、性别、教育、抑郁和医院病房聚类效应）后，基线时有认知脆弱、只有脆弱或只有认知障碍的住院患者均与跌倒史相关（P<0.05）。在 30 天随访时，经过全调整的广义估计方程显示，认知脆弱的住院患者跌倒风险高于非脆弱和认知完整的患者（OR=3.0，95%CI：1.32-6.83）。这一关联也在仅有脆弱的个体中观察到（OR=2.11，95%CI：1.04-4.27），但在仅有认知障碍的患者中并未观察到（OR=1.11，95%CI：0.43-2.85）。
我们的研究表明，中国住院老年患者认知脆弱与跌倒独立相关。临床医生应早期筛查脆弱和认知障碍，对老年患者进行相应的干预、运动训练和营养计划，以预防跌倒。
