Association of cognitive impairment with frailty in community-dwelling older adults

Background: 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. Methods: 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. Results: 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. Conclusions: 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.