The cross-sectional relationship of physical frailty and cognitive impairment in older Poles: analysis of the PolSenior2 data.

Abstract

Aim: To assess the relation between pre-frailty and frailty, and its components on one hand and the presence, degree and components of cognitive impairment.

Methods: This is a nationwide epidemiologic survey of health determinants in older Poles (PolSenior2). We assessed physical frailty using the approach by Fried et al. and cognitive impairment with the Mini-Mental Status Examination (MMSE). We calculated population estimates (95% CI) of conditions under study, with sampling weights to account for the complex survey design, with the age-sex post-stratification matching to the population of Poland. We used logistic regression to model cognitive impairment as function of frailty phenotype.

Results: Mean (SD) age of 5378 participants (58.0% women) was 75.0 (9.4) years. Frailty was diagnosed in 23.5% of respondents, and 54.6% were pre-frail. Normal cognition was found in 51.3%, 23.0% had suspected mild cognitive impairment (MCI), and suspected: 16.3% mild, 6.5% moderate and 2.9% severe dementia. Robust phenotype was present in 35.7% normal cognition persons, 4.7% in moderate dementia, and 0.0% in severe dementia. Frailty increased from 9.2% in normal cognition to 57.4% and 85.3% in moderate dementia and severe dementia. Frailty component that was associated with abnormalities in all MMSE domains was exhaustion. In the presence of exhaustion, the best-preserved function was registration, and the most pronounced was attention deficit.

Conclusion: Frailty and cognitive impairment are closely associated. While exhaustion was standing out among the frailty components, it was associated with impaired orientation and attention deficits. These data may inform both the prevention and rehabilitation and nutritional counseling.