Cognitive frailty is a robust predictor of falls, injuries, and disability among community-dwelling older adults

BACKGROUND: Cognitive frailty, a combination of physical frailty and cognitive impairment, is associated with functional decline in older adults. However, there is limited information if cognitive frailty predicts the incidence of falls, injuries, and disability. In this study, we aimed to determine the ability of cognitive frailty in predicting the incidence of falls, injuries and disability among multi-ethnic older adults in Malaysia at 5 years follow-up. METHODS: In this prospective cohort study, a total of 400 participants aged 60 years and above were successfully followed up at 5 years. Participants' socio-demographic, medical history, psycho-social, physical, cognitive and dietary intake information was obtained. Cognitive frailty was defined as comorbid physical frailty (> 1 Fried criteria) and mild cognitive impairment (Petersen criteria). Univariate analysis was performed for all variables, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls, injuries, and disability. The significant value was set at p < 0.05. RESULTS: Cognitive frailty was found to be associated with greater risk of adverse consequences after adjusting for covariates. Both cognitive frailty (Adjusted Odd ratio (Adj OR) = 2.98, 95% confidence interval (CI): 1.78-4.99, p < 0.05) and physical frailty (Adj OR = 2.88, 95% CI: 1.19-6.99, p < 0.05) were significant predictors of incidence of falls. Risk of injuries was also significantly increased with the presence of cognitive frailty (Adj OR = 3.06, 95% CI: 1.23-7.60, p < 0.05) and physical frailty (Adj OR = 3.04, 95% CI: 1.75-5.28, p < 0.05). In addition, cognitive frailty (Adj OR = 5.17, 95% CI: 1.11-24.21, p < 0.05) and physical frailty (Adj OR = 4.99, 95% CI: 1.11-22.57, p < 0.05) were shown to significantly predict the incidence of disability among older adults. CONCLUSION: Cognitive frailty is a robust predictor of falls, injuries, and disability in older adults. Possible early multi-domain preventive and management strategies of cognitive frailty that contribute to adverse consequences are required to decrease further functional decline and promote independence in older adults.