Kozak-Szkopek Elżbieta, Wdowiak Katarzyna, Imiela Anna M, Ou-Pokrzewińska Aisha, Strząska-Kliś Zuzanna, Andrzejczyk Agata, Czyżewski Łukasz
Department of Geriatric Nursing, Medical University of Warsaw, Warsaw, Poland.
Department of Internal Diseases and Cardiology, Centre for Management of Venous Thromboembolic Disease, Medical University of Warsaw, Warsaw, Poland.
Med Sci Monit. 2025 Sep 5;31:e947354. doi: 10.12659/MSM.947354.
BACKGROUND Frailty syndrome (FS) and cognitive impairment are major geriatric concerns, particularly prevalent among hospitalized older adults. The primary objective of this study was to assess the co-occurrence of FS and cognitive impairment in hospitalized geriatric patients. Additionally, the study analyzed the relationship of these conditions with functional status, fall risk, sensory deficits, depressive symptoms, and selected prognostic laboratory parameters. The research hypothesis was that the severity of frailty is correlated with worse cognitive impairment. MATERIAL AND METHODS This retrospective study analyzed the medical records of 265 patients consecutively admitted to the Internal Medicine and Geriatrics Ward of the Clinic of Internal Medicine and Cardiology at the University Clinical Centre of the Medical University of Warsaw (UCK WUM) between January 1 and December 31, 2022. During hospitalization, all patients underwent a comprehensive geriatric assessment (CGA), which included the following tools: the Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Instrumental Activities of Daily Living Scale (IADL), the Barthel Index, the Short Tinetti Test, the Norton Scale, the Mini-Mental State Examination (MMSE), and the 15-item Geriatric Depression Scale (GDS-15). Frailty was assessed using the Clinical Frailty Scale (CFS). Laboratory analysis included serum levels of albumin, hemoglobin, lymphocytes, sodium, and thyroid-stimulating hormone (TSH). RESULTS Most patients (64.77%) exhibited signs of frailty - 21.59% were classified as pre-frail and 13.63% were non-frail. Frailty severity was correlated with worsening cognitive impairment. Statistically significant associations were observed between CFS scores and clinical parameters such as age (P<0.001), albumin level (P<0.001), hemoglobin level (P=0.002), lymphocyte count (P=0.292), and MMSE score (P<0.001). Scores of functional assessment tools - ADL, IADL, the Norton Scale, the Barthel Index, and the Tinetti Test - were significantly correlated (P<0.05) with both CFS and MMSE outcomes. CONCLUSIONS In hospitalized geriatric patients, frailty severity is associated with cognitive decline and decreased functional performance. Lower levels of albumin and lymphocytes were associated with more advanced frailty and worse cognitive dysfunction.
衰弱综合征（FS）和认知障碍是老年医学领域的主要关注点，在住院老年人中尤为普遍。本研究的主要目的是评估住院老年患者中FS和认知障碍的共现情况。此外，该研究分析了这些情况与功能状态、跌倒风险、感觉缺陷、抑郁症状以及选定的预后实验室参数之间的关系。研究假设是衰弱的严重程度与更严重的认知障碍相关。
这项回顾性研究分析了2022年1月1日至12月31日期间连续入住华沙医科大学大学临床中心内科与心脏病科内科及老年病科病房的265例患者的病历。住院期间，所有患者均接受了全面的老年综合评估（CGA），其中包括以下工具：日常生活活动能力 Katz 指数（ADL）、日常生活活动能力量表（IADL）、Barthel指数、简短Tinetti测试、Norton量表、简易精神状态检查表（MMSE）以及15项老年抑郁量表（GDS - 15）。使用临床衰弱量表（CFS）评估衰弱情况。实验室分析包括血清白蛋白、血红蛋白、淋巴细胞、钠和促甲状腺激素（TSH）水平。
大多数患者（64.77%）表现出衰弱迹象——21.59%被归类为衰弱前期，13.63%为非衰弱。衰弱严重程度与认知障碍恶化相关。在CFS评分与年龄（P<0.001）、白蛋白水平（P<0.001）、血红蛋白水平（P = 0.002）、淋巴细胞计数（P = 0.292）和MMSE评分（P<0.001）等临床参数之间观察到具有统计学意义的关联。功能评估工具——ADL、IADL、Norton量表、Barthel指数和Tinetti测试——的评分与CFS和MMSE结果均显著相关（P<0.05）。
在住院老年患者中，衰弱严重程度与认知能力下降和功能表现降低相关。较低的白蛋白和淋巴细胞水平与更严重的衰弱和更差的认知功能障碍相关。
