@article{ce13c9885ed941339e174a32a6e1cc76,
title = "Cognitive frailty in relation to adverse health outcomes independent of multimorbidity: results from the China health and retirement longitudinal study",
abstract = "Our objectives were to evaluate: 1) the associations of cognitive frailty with various health outcomes including disability hospitalization and death; 2) whether the associations differed by multimorbidity. We included data of 5113 Chinese older adults (aged 60+ years) who had baseline cognition and physical frailty assessments (2011 wave) and follow-up for 4 years. About 16.0% (n=820) had cognitive impairment; 6.7% (n=342) had physical frailty; and 1.6% (n=82) met criteria for cognitive frailty. Both cognitive impairment (odds ratios (ORs) range: 1.41 to 2.11) and physical frailty (ORs range: 1.51 to 2.43) were independently associated with basic activities of daily living (BADL) instrumental ADL (IADL) mobility disability hospitalization and death among participants without that corresponding outcome at baseline even after accounting for covariates. Relative to participants who had normal cognition and were nonfrail those with cognitive frailty had the highest risk for IADL disability (OR=3.40 95% CI 1.23–9.40) and death (OR=3.89 95% CI 2.25–6.47). We did not find significant interaction effects between cognitive frailty and multimorbidity (Pinteractions=0.05). Overall cognitive frailty was associated with disability and death independent of multimorbidity. This highlights the importance of assessing cognitive frailty in the community to promote primary and secondary preventions for healthy aging.",
keywords = "cognitive frailty, death, disability, multimorbidity, older adults",
author = "Chen Chen and Park, {Ju Young} and Chenkai Wu and Xue, {Qian Li} and George Agogo and Ling Han and Hoogendijk, {Emiel O.} and Zuyun Liu and Zunyou Wu",
note = "Funding Information: National Natural Science Foundation of China (70773002, 70910107022, and 71130002), and the World Bank (7159234) for the support for the CHARLS. The current study was conducted partially at School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine (Hundred Talents Program). This study was supported by the Fundamental Research Funds for the Central Universities (China); and an NWO/ZonMw Veni fellowship (91618067). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0) which permits unrestricted use distribution and reproduction in any medium provided the original author and source are credited. FUNDING The data used in this study are from China Health and Retirement Longitudinal Study (CHARLS). We thank the National Institute on Aging (NIA) in the United States (1-R21-AG031372-01 1-R21-AG033675-01-A1 1-R01-AG037031-01 and 1-R01-AG037031-03S1) the National Natural Science Foundation of China (70773002 70910107022 and 71130002) and the World Bank (7159234) for the support for the CHARLS. The current study was conducted partially at School of Public Health and the Second Affiliated Hospital Zhejiang University School of Medicine (Hundred Talents Program). This study was supported by the Fundamental Research Funds for the Central Universities (China); and an NWO/ZonMw Veni fellowship (91618067). The funders had no role in study design data collection and analysis decision to publish or preparation of the manuscript. ACKNOWLEDGMENTS We thank all participants in the China Health and Retirement Longitudinal Study. We thank the CHARLS research team for providing the data. We thank Jennifer M. McGoogan for comments and editing assistance. Publisher Copyright: {\textcopyright} 2020. Chen et al. All Rights Reserved.",
year = "2020",
month = nov,
doi = "10.18632/aging.104078",
language = "English (US)",
volume = "12",
pages = "23129--23145",
journal = "Aging",
issn = "1945-4589",
publisher = "US Administration on Aging",
number = "22",
}