[Cognitive state as a conditioner of frailty in the elderly. Perspective from a health centre].
OBJECTIVE
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 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).


CONCLUSIONS
Cognitive impairment marks the appearance in a significant form of frailty factors in the elderly, such as falls, urinary incontinence, hospitalisation-readmissions and depression. This relation is not only appreciable in patients with an established cognitive impairment (MEC<24 points), but there is also a trend to appear as this impairment progresses, with a statistical relation for falls, urinary incontinence, hospitalisation-readmissions and pluripathology.
Hervás
A
A
Centro de Salud de Tafalla, Tafalla, Navarra. adolhervas@hotmail.com
García de Jalón
E
E
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D015995:Prevalence; D011320:Primary Health Care; D012307:Risk Factors