Longitudinal Study On The Effects Of Frailty And Mild Cognitive Impairment On The Quality Of Life Of Elderly Patients With Chronic Obstructive Pulmonary Disease

Objective:The aim of this longitudinal research is to assess frailty and mild cognitive impairment in elderly individuals suffering from chronic obstructive pulmonary disease(COPD).Grasping the occurrence and alteration of frailty and MCI in elderly individuals with chronic obstructive pulmonary disease(COPD)during hospitalization and 6 months after release is essential.To investigatethe frailty and MCI of elderly COPD patients,with a view to providing individualized treatment and intervention options for healthcare professionals,is the current focus.An examination of the influence of frailty and MCI in hospitalization on the quality of life 6 months post-discharge is being conducted.To analyze the predictive effect of frailty and MCI during hospitalization on the quality of life 6 months after discharge.InvestigatingMethods:From January 2022 to June 2022,245 elderly COPD patients were enrolled in Class A hospital in Hohhot,Inner Mongolia,by means of questionnaire survey and convenient sampling method.During hospitalization(T1),Frailty Scale(FRAIL Scale),the Mini-mental State Examinination Scale(MMSE),and the COPD Assessment Test(CAT)were used to assess patients’frailty,cognitive function and quality of life respectively.In addition,demographic characteristics of patients were collected using a self-generated general information scale.Simultaneously,we used the Barthel Index,Short-Form Mini Nutritional Assessment(MNA-SF),modified British medical research council(m MRC),and Short From Geriatric De Pression Scale-15(GDS-15)to assess patients’self-care ability,nutritional status dyspnea symptoms,and depression,respectively.Patients were followed up 6 months after discharge(T2)to collect data about their physical frailty,MCI and quality of life.We used SPSS25.0 software for data analysis,including statistical profiling,paired samples Wilcoxon test,chi-square testing,binary logistic regression analysis,Pearson correlation analysis.Finally,a cross-lagged panel model established using Amos25.0 software to analyze the predictive effect of frailty and mild cognitive impairment on quality of life in patients.Results:1.Incidence and score of frailty and MCI in elderly patients with COPD,during hospitalization and 6 months after discharge and changes in the degree of impact on patients’quality of life.The incidence of frailty during hospitalization and 6 months after hospital discharge were 54.93%and 41.78%respectively,there was a significant differences in incidence of frailty between the two phases(X~2=7.369,P<0.05).The frailty scores were 3(2 to 3)and 2(1to 3),respectively,with statistically significant differences(P<0.001)between the two time points.The prevalence of patients with MCI during hospitalization and 6 months after discharge was 41.63%and 46.48%respectively,and there was no statistically significant difference in the prevalence(X2=2.155,P>0.05)and scores(Z=-2.36,P>0.05)of MCI between the two stages.The quality of life was moderately affected by 15.96%of patients,severely affected by67.14%of patients,and very severely affected by 16.90%of patients during hospitalization;after discharge,the quality of life was moderately affected by 38.50%of patients,severely affected by 48.36%of patients,and very severely affected by 13.15%of patients,and the degree of quality of life in the two stages was statistically significant difference(Z=-7.58,P<0.001),and the quality of life scores of patients in the two stages were 25(22to29)and 22(19to27),respectively,and there was a statistical difference between the quality of life scores of patients in the two stages(P<0.001).2.Analysis results of influencing factors of frailty and mild cognitive impairment in patients with COPDThis study showed that MMSE score(OR=1.149,P<0.05),m MRC classification≥2(OR=2.543,P<0.05),polypharmacy(OR=2.204,P<0.05),and Bl index score(OR=1.039,P<0.05)were independent risk factors for the development of frailty in patients with COPD(P<0.05),and CAT score was a protective factor for the development of frailty(OR=0.851,P<0.05).Age(OR=3.139,P<0.05)and gender(OR=1.093,P<0.05)were independent risk factors for the occurrence of MCI in elderly patients with COPD,and literacy was a protective factor for the occurrence of MCI in elderly patients with chronic obstructive pulmonary disease(OR=0.236,P<0.05).3.Results of cross-lagged analysis between debilitation,mild cognitive impairment and patients’quality of life in elderly patients with COPD.Frailty during hospitalization in elderly patients with COPD positively and significantly predicted quality of life 6 months after discharge(β=0.199,SE=0.322,P<0.001);mild cognitive impairment during hospitalization significantly and negatively predicted quality of life 6 months after discharge(β=-0.12,SE=0.084,P<0.05);and mild cognitive impairment during hospitalization during hospitalization significantly and negatively predicted patients’frailty condition 6 months after discharge(β=-0.106,SE=0.017,P<0.05).Conclusion1.The prevalence of frailty in elderly COPD patients during hospitalization to 6 months after discharge was decreasing,and the degree of frailty was decreasing;There is no significant change in prevalence and score of MCI;the degree of impact on quality of life was decreasing,and the quality of life was improving.2.Elderly patients with COPD have a higher incidence of frailty and MCI during hospitalization and should be evaluated and interfered with early.3.Incidence of frailty and mild cognitive impairment during hospitalization in elderly patients with COPD can predict quality of life after hospital discharge.4.There was no interaction between frailty and mild cognitive impairment.