The Power of Cognitive Frailty in Predicting Falls among Older Adults

Published on January 13, 2023

Imagine that your brain and body are parts of a well-oiled machine. But what happens when some parts start to wear down? This study investigated the association between cognitive frailty (CF) and falls among older adults in China. CF is like having a faulty cog in the brain-body machine, where cognitive impairment (CoI) and frailty intersect. The researchers wanted to know if older adults with CF were at a higher risk of falls compared to those with only CoI or frailty. They found that CF had a more cumulative effect on falls than CoI or frailty alone. This means that when both cognitive function and frailty are compromised, the risk of falling increases. The study also developed a fall prediction model based on CF and other factors such as age, sex, and physical disabilities. The model showed moderate accuracy in predicting fall risk. These findings highlight the importance of assessing both cognitive function and frailty status in older adults to identify those at risk of falling. So, next time you see your brain as the engine of your well-being, remember that maintaining its health is crucial for preventing falls!

BackgroundThe combined effect of cognitive impairment (CoI) and frailty on falls is controversial. This study aimed to explore whether older adults with cognitive frailty (CF) were at a higher risk of falls than those with only CoI or frailty and to present a fall prediction model based on CF.MethodsA total of 4,067 adults aged ≥ 60 years were included from the Chinese Longitudinal Healthy Longevity Survey through face-to-face interviews. Cognitive function and frailty were assessed using the mini-mental state examination scale and frailty index, respectively. Logistic regression was used to determine fall-associated risk factors and develop a fall prediction model. A nomogram was then plotted. The model performance was evaluated using the area under the curve (AUC), concordance index (C-index), and calibration curve. All analyses were performed using SPSS and R statistical packages.ResultsThe prevalence of CF and falls were 1.4 and 19.4%, respectively. After adjusting for covariates, the odds ratio of CF, frailty only, and CoI only for falls were 2.27 (95% CI: 1.29–3.97), 1.41 (95% CI: 1.16–1.73), and 0.99 (95% CI: 0.43–2.29), respectively. CF, sex, age, hearing difficulty, depression, anxiety, disability in instrumental activities of daily living, and serious illness in the past 2 years were independently associated with falls. A prediction model based on these factors yielded an AUC of 0.646 and a C-index of 0.641.ConclusionCognitive frailty (CF) exerted a cumulative effect on falls than did CoI or frailty alone. Joint assessments of cognitive function and frailty status may be beneficial for fall risk screening in community. A prediction model using CF as a factor could be helpful for this process.

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