Frailty and cognitive impairment as predictors of mortality in older Mexican Americans

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Abstract

Objective: Examine the association between frailty and cognitive impairment as predictors of mortality over a 10-year period in a selected sample of older mexican americans. Design: Longitudinal analyses using data from the hispanic established populations for the epidemiologic Study of the elderly (1995-96/2004-05). Setting: Five southwestern states: Texas, new mexico, Colorado, arizona, and California. Participants: Mexican Americans aged 67 and older with complete information on the frailty index and the mini mental State examination (MMSE) (n=1,815). Measurements: Cognitive impairment determined by a score in the MMSE < 21. Frailty defined as three or more of the following components: 1) weight-loss, 2) weakness, 3) self-reported exhaustion, 4) slow walking speed, and 5) low physical activity level. Sociodemographic characteristics and chronic medical conditions were used as covariates. Mortality was determined using the national death index or by proxy. Results: As MMSE score declines over time, the percent of frail individuals increases in a linear fashion. Frailty and cognitive impairment are independent risk factors for mortality after controlling for all covariates (HR 2.03 95% CI 1.57-2.62; HR 1.26 95% CI 1.05-1.52, respectively). When both cognitive impairment and frailty were added to the model, HR for individuals with cognitive impairment was no longer statistically significant. Conclusion: The relation between frailty and cognitive impairment needs careful analysis in this population to establish pathways increasing mortality and decreasing quality of life. Our results suggest frailty is a stronger predictor of mortality for older mexican americans than cognitive impairment.

Original languageEnglish (US)
Pages (from-to)142-147
Number of pages6
JournalJournal of Nutrition, Health and Aging
Volume16
Issue number2
DOIs
StatePublished - Feb 2012

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Mortality
Proxy
Cognitive Dysfunction
Hispanic Americans
Population
Weight Loss
Epidemiologic Studies
Quality of Life
Exercise

Keywords

  • Cognitive impairment
  • Frailty
  • Mexican americans
  • Mortality

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics
  • Geriatrics and Gerontology

Cite this

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title = "Frailty and cognitive impairment as predictors of mortality in older Mexican Americans",
abstract = "Objective: Examine the association between frailty and cognitive impairment as predictors of mortality over a 10-year period in a selected sample of older mexican americans. Design: Longitudinal analyses using data from the hispanic established populations for the epidemiologic Study of the elderly (1995-96/2004-05). Setting: Five southwestern states: Texas, new mexico, Colorado, arizona, and California. Participants: Mexican Americans aged 67 and older with complete information on the frailty index and the mini mental State examination (MMSE) (n=1,815). Measurements: Cognitive impairment determined by a score in the MMSE < 21. Frailty defined as three or more of the following components: 1) weight-loss, 2) weakness, 3) self-reported exhaustion, 4) slow walking speed, and 5) low physical activity level. Sociodemographic characteristics and chronic medical conditions were used as covariates. Mortality was determined using the national death index or by proxy. Results: As MMSE score declines over time, the percent of frail individuals increases in a linear fashion. Frailty and cognitive impairment are independent risk factors for mortality after controlling for all covariates (HR 2.03 95{\%} CI 1.57-2.62; HR 1.26 95{\%} CI 1.05-1.52, respectively). When both cognitive impairment and frailty were added to the model, HR for individuals with cognitive impairment was no longer statistically significant. Conclusion: The relation between frailty and cognitive impairment needs careful analysis in this population to establish pathways increasing mortality and decreasing quality of life. Our results suggest frailty is a stronger predictor of mortality for older mexican americans than cognitive impairment.",
keywords = "Cognitive impairment, Frailty, Mexican americans, Mortality",
author = "C. Cano and {Samper Ternent}, Rafael and {Al Snih al snih}, Soham and Kyriakos Markides and Kenneth Ottenbacher",
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T1 - Frailty and cognitive impairment as predictors of mortality in older Mexican Americans

AU - Cano, C.

AU - Samper Ternent, Rafael

AU - Al Snih al snih, Soham

AU - Markides, Kyriakos

AU - Ottenbacher, Kenneth

PY - 2012/2

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N2 - Objective: Examine the association between frailty and cognitive impairment as predictors of mortality over a 10-year period in a selected sample of older mexican americans. Design: Longitudinal analyses using data from the hispanic established populations for the epidemiologic Study of the elderly (1995-96/2004-05). Setting: Five southwestern states: Texas, new mexico, Colorado, arizona, and California. Participants: Mexican Americans aged 67 and older with complete information on the frailty index and the mini mental State examination (MMSE) (n=1,815). Measurements: Cognitive impairment determined by a score in the MMSE < 21. Frailty defined as three or more of the following components: 1) weight-loss, 2) weakness, 3) self-reported exhaustion, 4) slow walking speed, and 5) low physical activity level. Sociodemographic characteristics and chronic medical conditions were used as covariates. Mortality was determined using the national death index or by proxy. Results: As MMSE score declines over time, the percent of frail individuals increases in a linear fashion. Frailty and cognitive impairment are independent risk factors for mortality after controlling for all covariates (HR 2.03 95% CI 1.57-2.62; HR 1.26 95% CI 1.05-1.52, respectively). When both cognitive impairment and frailty were added to the model, HR for individuals with cognitive impairment was no longer statistically significant. Conclusion: The relation between frailty and cognitive impairment needs careful analysis in this population to establish pathways increasing mortality and decreasing quality of life. Our results suggest frailty is a stronger predictor of mortality for older mexican americans than cognitive impairment.

AB - Objective: Examine the association between frailty and cognitive impairment as predictors of mortality over a 10-year period in a selected sample of older mexican americans. Design: Longitudinal analyses using data from the hispanic established populations for the epidemiologic Study of the elderly (1995-96/2004-05). Setting: Five southwestern states: Texas, new mexico, Colorado, arizona, and California. Participants: Mexican Americans aged 67 and older with complete information on the frailty index and the mini mental State examination (MMSE) (n=1,815). Measurements: Cognitive impairment determined by a score in the MMSE < 21. Frailty defined as three or more of the following components: 1) weight-loss, 2) weakness, 3) self-reported exhaustion, 4) slow walking speed, and 5) low physical activity level. Sociodemographic characteristics and chronic medical conditions were used as covariates. Mortality was determined using the national death index or by proxy. Results: As MMSE score declines over time, the percent of frail individuals increases in a linear fashion. Frailty and cognitive impairment are independent risk factors for mortality after controlling for all covariates (HR 2.03 95% CI 1.57-2.62; HR 1.26 95% CI 1.05-1.52, respectively). When both cognitive impairment and frailty were added to the model, HR for individuals with cognitive impairment was no longer statistically significant. Conclusion: The relation between frailty and cognitive impairment needs careful analysis in this population to establish pathways increasing mortality and decreasing quality of life. Our results suggest frailty is a stronger predictor of mortality for older mexican americans than cognitive impairment.

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