Cognitive state as a conditioner of frailty in the elderly. Perspective from a health centre

AIM: To determine the influence of the cognitive state on the presence of different frailty factors in the elderly. METHODS: Study of an outpatient elderly population with chronic diseases (resident at home or institutionalised), the presence of different frailty risk factors and their relation to cognitive state (measured using the mini-mental state examination-MEC). RESULTS: Study of 147 elderly people with an average age of 71.4 years and a similar proportion of men (74; 50.3%) and women (73; 49.7%). Thirty-four subjects (23.1%) institutionalised in residences. The percentage of patients showing cognitive impairment (MEC<24 points) is 12.9% (19 cases). Presence of frailty risk factors: low social support: 7.5% (11); falls: 17% (25); urinary incontinence: 18.4% (27); depression: 13.6% (20); anxiety-insomnia: 29.9% (44); hospitalisation-readmissions: 21.8% (32); multiple="multiple" medications (>3 medicines): 53.7% (79); pluripathology (> or =3 diseases): 36.1% (53). The frailty factors that have a significant relation in patients with cognitive impairment (MEC<24) are falls [OR=59.5 (CI 95%=14.7-240.6)] (p<0.0001), urinary incontinence [OR=31.2 (8.9-109.1)] (p<0.0001), hospitalisation-readmissions [OR=32.9 (8.6-125.8)] (p<0.0001) and depression [OR=7.8 (2.5-23.5)] (p<0.0001). With respect to scoring on the MEC by percentiles, the risk factors that showed a tendency of lineal appearance are falls (p<0.0001), urinary incontinence (p<0.0001), hospitalisation-readmissions (p<0.0001) and pluripathology (p=0.002).

Hervás A, García de Jalón E. Cognitive state as a conditioner of frailty in the elderly. Perspective from a health centre?. An Sist Sanit Navar. 2005; 28(1): 35-47.

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