Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans

Research output: Contribution to journalArticle

Abstract

Objectives: Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans. Methods: Data for this analysis came from the 2006–2007 and 2010–2011 waves of the Hispanic EPESE. The final sample included 639 Mexican Americans aged ≥77 years who were non-frail or pre-frail in 2006–2007. Frailty measure included weight loss, exhaustion, weakness, and slow walking speed. Participants were classified as non-frail (0 criteria) and pre-frail (1 criterion) at baseline. Cognitive impairment was defined as <21 points on the MMSE. At baseline, participants were grouped as: cognitively intact non-frail, cognitively intact pre-frail, cognitively impaired non-frail, and cognitively impaired pre-frail. Logistic and hazard regression models were used to evaluate the odds of being frail in 2010–2011 and risk for 10-year mortality. Results: Cognitively impaired pre-frail participants were more likely to become frail (OR = 4.82, 95% CI = 2.02–11.42) and deceased (HR = 1.99, 95% CI = 1.42–2.78). Cognitively impaired non-frail participants had significantly higher risk for mortality (HR = 1.55, 95% CI = 1.12–2.19) but not frailty (OR = 1.29, 95% CI = 0.50–3.11). Being cognitively intact and pre-frail at baseline was not significantly associated with being frail at follow-up (OR = 1.62, 95% CI = 0.83–3.19) or mortality (HR = 1.29, 95% CI = 0.97–1.71). Conclusions: Comorbid cognitive impairment and pre-frailty is associated with future frailty and mortality in older Mexican Americans. Screening for cognitive impairment may be effective for identifying pre-frail Mexican Americans who are at the highest risk of frailty and mortality.

Original languageEnglish (US)
JournalAging and Mental Health
DOIs
StateAccepted/In press - Jan 1 2018

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Mortality
Hispanic Americans
Proportional Hazards Models
Cognition
Cognitive Dysfunction
Weight Loss
Logistic Models
Health
Research

Keywords

  • Cognitive functioning
  • functional status
  • Hispanic aging

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

@article{5756a4759d1744a6a398495f4cccd6d2,
title = "Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans",
abstract = "Objectives: Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans. Methods: Data for this analysis came from the 2006–2007 and 2010–2011 waves of the Hispanic EPESE. The final sample included 639 Mexican Americans aged ≥77 years who were non-frail or pre-frail in 2006–2007. Frailty measure included weight loss, exhaustion, weakness, and slow walking speed. Participants were classified as non-frail (0 criteria) and pre-frail (1 criterion) at baseline. Cognitive impairment was defined as <21 points on the MMSE. At baseline, participants were grouped as: cognitively intact non-frail, cognitively intact pre-frail, cognitively impaired non-frail, and cognitively impaired pre-frail. Logistic and hazard regression models were used to evaluate the odds of being frail in 2010–2011 and risk for 10-year mortality. Results: Cognitively impaired pre-frail participants were more likely to become frail (OR = 4.82, 95{\%} CI = 2.02–11.42) and deceased (HR = 1.99, 95{\%} CI = 1.42–2.78). Cognitively impaired non-frail participants had significantly higher risk for mortality (HR = 1.55, 95{\%} CI = 1.12–2.19) but not frailty (OR = 1.29, 95{\%} CI = 0.50–3.11). Being cognitively intact and pre-frail at baseline was not significantly associated with being frail at follow-up (OR = 1.62, 95{\%} CI = 0.83–3.19) or mortality (HR = 1.29, 95{\%} CI = 0.97–1.71). Conclusions: Comorbid cognitive impairment and pre-frailty is associated with future frailty and mortality in older Mexican Americans. Screening for cognitive impairment may be effective for identifying pre-frail Mexican Americans who are at the highest risk of frailty and mortality.",
keywords = "Cognitive functioning, functional status, Hispanic aging",
author = "Brian Downer and {Al Snih al snih}, Soham and Bret Howrey and Mukaila Raji and Kyriakos Markides and Kenneth Ottenbacher",
year = "2018",
month = "1",
day = "1",
doi = "10.1080/13607863.2018.1493719",
language = "English (US)",
journal = "Aging and Mental Health",
issn = "1360-7863",
publisher = "Taylor and Francis Ltd.",

}

TY - JOUR

T1 - Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans

AU - Downer, Brian

AU - Al Snih al snih, Soham

AU - Howrey, Bret

AU - Raji, Mukaila

AU - Markides, Kyriakos

AU - Ottenbacher, Kenneth

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans. Methods: Data for this analysis came from the 2006–2007 and 2010–2011 waves of the Hispanic EPESE. The final sample included 639 Mexican Americans aged ≥77 years who were non-frail or pre-frail in 2006–2007. Frailty measure included weight loss, exhaustion, weakness, and slow walking speed. Participants were classified as non-frail (0 criteria) and pre-frail (1 criterion) at baseline. Cognitive impairment was defined as <21 points on the MMSE. At baseline, participants were grouped as: cognitively intact non-frail, cognitively intact pre-frail, cognitively impaired non-frail, and cognitively impaired pre-frail. Logistic and hazard regression models were used to evaluate the odds of being frail in 2010–2011 and risk for 10-year mortality. Results: Cognitively impaired pre-frail participants were more likely to become frail (OR = 4.82, 95% CI = 2.02–11.42) and deceased (HR = 1.99, 95% CI = 1.42–2.78). Cognitively impaired non-frail participants had significantly higher risk for mortality (HR = 1.55, 95% CI = 1.12–2.19) but not frailty (OR = 1.29, 95% CI = 0.50–3.11). Being cognitively intact and pre-frail at baseline was not significantly associated with being frail at follow-up (OR = 1.62, 95% CI = 0.83–3.19) or mortality (HR = 1.29, 95% CI = 0.97–1.71). Conclusions: Comorbid cognitive impairment and pre-frailty is associated with future frailty and mortality in older Mexican Americans. Screening for cognitive impairment may be effective for identifying pre-frail Mexican Americans who are at the highest risk of frailty and mortality.

AB - Objectives: Impaired cognition and pre-frailty are associated with poor health outcomes. However, research has not examined the combined impact of cognitive impairment and pre-frailty on future frailty and mortality among older Mexican Americans. Methods: Data for this analysis came from the 2006–2007 and 2010–2011 waves of the Hispanic EPESE. The final sample included 639 Mexican Americans aged ≥77 years who were non-frail or pre-frail in 2006–2007. Frailty measure included weight loss, exhaustion, weakness, and slow walking speed. Participants were classified as non-frail (0 criteria) and pre-frail (1 criterion) at baseline. Cognitive impairment was defined as <21 points on the MMSE. At baseline, participants were grouped as: cognitively intact non-frail, cognitively intact pre-frail, cognitively impaired non-frail, and cognitively impaired pre-frail. Logistic and hazard regression models were used to evaluate the odds of being frail in 2010–2011 and risk for 10-year mortality. Results: Cognitively impaired pre-frail participants were more likely to become frail (OR = 4.82, 95% CI = 2.02–11.42) and deceased (HR = 1.99, 95% CI = 1.42–2.78). Cognitively impaired non-frail participants had significantly higher risk for mortality (HR = 1.55, 95% CI = 1.12–2.19) but not frailty (OR = 1.29, 95% CI = 0.50–3.11). Being cognitively intact and pre-frail at baseline was not significantly associated with being frail at follow-up (OR = 1.62, 95% CI = 0.83–3.19) or mortality (HR = 1.29, 95% CI = 0.97–1.71). Conclusions: Comorbid cognitive impairment and pre-frailty is associated with future frailty and mortality in older Mexican Americans. Screening for cognitive impairment may be effective for identifying pre-frail Mexican Americans who are at the highest risk of frailty and mortality.

KW - Cognitive functioning

KW - functional status

KW - Hispanic aging

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