Self-Reported Cognitive Frailty Predicts Adverse Health Outcomes for Community-Dwelling Older Adults Based on an Analysis of Sex and Age

• Published in: The Journal of nutrition, health & aging Vol. 23; no. 7; pp. 654 - 664
• Main Authors: Okura, Mika, Ogita, M., Arai, H.
• Format: Journal Article
• Language: English
• Published: Paris Springer Paris 01.07.2019; Springer Nature B.V
• Subjects: Age; Aged; Aged, 80 and over; Aging; Checklist; Cognition & reasoning; Cognition - physiology; Cohort Studies; Female; Frail Elderly - statistics & numerical data; Frailty; Frailty - diagnosis; Frailty - mortality; Gender; Geriatrics/Gerontology; Health risk assessment; Humans; Independent Living; Insurance, Long-Term Care; Japan - epidemiology; Male; Medicine; Medicine & Public Health; Mobility; Mobility Limitation; Mortality; Neurosciences; Nutrition; Older people; Prevalence; Primary Care Medicine; Prospective Studies; Quality of Life Research; Self Report - statistics & numerical data; Japan; long-term care insurance; mortality; older adults; Frailty; cognitive impairment; mobility disorders
• ISSN: 1279-7707; 1760-4788
• DOI: 10.1007/s12603-019-1217-7

Objectives The present study examined whether the combination of self-reported mobility decline (SR-MD) and cognitive decline (SR-CD) was associated with mortality and new long-term care insurance (LTCI) service certifications based on sex and age. Design A prospective cohort study. Setting and Participants We analyzed cohort data from a sample of older adult residents in Kami Town, Japan. The response rate was 94.3%, and we followed 5,094 older adults for 3 years. Full analyses were conducted on 5,076 participants. Measures A total of four groups were determined through self-reported responses on the Kihon Checklist for SR-MD (a score of 3 or more on 5 items) and SR-CD (a score of 1 or more on 3 items): non-SR-cognitive frailty, non-SR-MD & SR-CD, SR-MD & non-SR-CD, and SR-cognitive frailty. Results Main outcomes included mortality (n = 262) or new certifications for LTCI services (n = 708) during the 3-year period. Excluding overlapping, this included 845 older adults (16.6%). Among men, prevalence of non-SR-cognitive frailty, non-SR-MD & SR-CD, SR-MD & non-SR-CD, and SR-cognitive frailty (SR-MD & SR-CD) was 48.2%, 26.4%, 11.5%, and 13.8%, respectively. Respective rates for women were 45.7%, 15.5%, 23.1%, and 15.7%. Multivariate analyses revealed that for men, SR-MD & non-SR-CD significantly affected adverse health outcomes, leading to earlier negative outcomes relative to the non-SR-MD & SR-CD group. For women, non-SR-MD & SR-CD and SR-MD & non-SR-CD had similar slopes. Conclusions The impact of SR-MD or SR-CD on adverse health outcomes differed as a function of age and sex. Thus, we need to consider preventive approaches according to these specific target group features.