The Prevalence Of Cognitive Frailty And Its Impact On Activities Of Daily Living Among Older Adults In The Bouyei Region Of Guizhou Province

Objective:To understand the prevalence and influencing factors of cognitive frailty(CF)of the older people in the Bouyei ethnic areas of Guizhou Province,analyze the relationship between mild cognitive impairment(MCI),physical frailty(PF),and CF,as well as the impact of CF on activities of daily living(ADL),in order to explore the causes of CF and provide a scientific basis for promoting the health of the older adults.Methods:In July to August of 2019,the multi-stage cluster random sampling method was used to select 1 652 elderly residents(≥60 years old)from Bouyei nationality areas in Guiding county and Huaxi district of Guizhou as the subjects.The investigation was performed with a questionnaire,physical examination,and laboratory tests.The mini-mental state examination scale and frailty phenotype assessment tool were used to investigate the prevalence of MCI and PF in the study subjects.In the case of excluding dementia,a person with both MCI and PF was CF.The ADL scale includes basic activities of daily living(BADL)and instrumental activities of daily living(IADL).c~2test and trendc~2test inspection was used to analyze the data,the multivariate logistic regression was used to analyze the influencing factors of CF and compare the effects of CF with PF and MCI on ADL damage,the used software was SPSS17.0.The effect sizes of PF versus MCI on CF were analyzed using the AMOS21.0 software pathway.Results:1.The morbidity of CF,PF,and MCI was 3.3%,12.9%,and 17.2%,respectively.The morbidity(2.3%)of CF in males was significantly lower than that(4.1%)in females;the morbidity of CF increased with age(P<0.05).2.The multivariate logistic regression analysis showed that the higher annual family income(OR=0.229,95%CI;0.086-0.614)and hobbies(OR=0.385,95%C1;0194-0.764)were associated with a lower risk of CF in elderly residents;abnormal high-density lipoprotein(HDL-C)(OR=2.564,95%CI;1.161-5.660)was associated with a high risk of CF in the elderly residents.3.Pathway analysis of CF in older adults showed that PF had a direct effect on CF(pathway coefficient of 0.45,P<0.01),and was higher than the direct effect of MCI on CF(pathway coefficient of 0.368,P<0.01).Logistic regression showed that there was an association between PF and MCI,and in turn,MCI could directly affect PF(pathway coefficient of 0.088,P<0.01),and MCI could also influence PF to have an indirect effect on CF(pathway coefficient of 0.040,P<0.01).4.The rate of ADL impairment in older adults in the Bouyei region of Guizhou Province was 20.0%,including 1.6%for BADL impairment and 40.9%for IADL impairment.Multifactorial logistic regression was used to compare the effects of CF with PF and MCI on ADL impairment,BADL impairment and IADL impairment,and after adjusting for relevant confounding variables,both PF(OR=2.612,95%CI;1.697-4.018)and MCI(OR=4.429,95%CI;3.029-6.476)in older adults were associated with ADL impairment,and CF(OR=5.267,95%CI;2.434-11.396)was associated with higher strength of ADL impairment.Among the elderly,both CF(OR=15.384,95%CI;4.575-51.738)and MCI(OR=2.838,95%CI;1.015-7.938)were associated with BADL impairment,and PF(OR=24.253,95%CI;7.368-79.829)was more strongly associated with BADL impairment.Both PF(OR=2.067,95%CI;1.368-3.122)and MCI(OR=3.776,95%CI;2.623-5.435)were associated with IADL impairment in older adults,and CF(OR=4.985,95%CI;2.048-12.139)was associated with a higher strength of association with IADL impairment.Conclusions:1.The prevalence of CF among the older adults in the Bouyei region of Guizhou Province is close to that of other regions,the elderly residents with low family income,without hobby and abnormal blood lipoprotein levels were people with high risk of CF,the elderly residents should take part in social action,control the abnormal blood lipoprotein and prevent CF.2.The direct effect of CF was greater in older adults with a high prevalence of PF,and the interconnections that exist between PF and MCI might have a different pathway to CF,which needs to be confirmed by prospective cohort studies in the future.3.The strength of the association between CF and impaired ADL and impaired IADL was higher than that of PF and MCI only,suggesting that CF may be more detrimental to ADL in the older adults,especially IADL,and that the attention to CF in the older adults should be strengthened.