title: Severe frailty and cognitive impairment are related to higher mortality in 12-month follow-up of nursing home residents.
abstract: Frailty syndrome (FS) and cognitive impairment are associated with an increased risk of falls, disability, hospitalization and death. We investigated prognostic meaning of FS and cognitive impairment in persons ≥ 65 years, living in 2 nursing homes. Information about the health status of patients was gathered from history, medical documentation, test assessing FS, according to the Canadian Study of Health and Aging-Clinical Frailty Scale (CSHA-CFS) and the Mini-Mental State Examination (MMSE). The study group included 66 women and 20 men, between 66 and 101 years of age (mean ± S.D.=83.8 ± 8.3 years). The frequency of severe frailty (CSHA-CFS=7) among the elderly living in nursing homes was 34.9%, while severe cognitive impairment (MMSE<18) was present in 55.8%. Residents with severe FS and MMSE<18 consisted 33.7% of examined and 50.0% of those who died during 12-month follow-up, p<0.05. Individuals with severe FS and severe cognitive impairment (n=29) as compared to all other patients, were significantly less probable (59% vs. 79%, p=0.03) to survive one year. Neither frailty, nor dementia, nor severe FS or cognitive impairment when considered separately was associated with higher mortality rate. The risk assessment in severely disabled geriatric patients is best performed with measures of functional and cognitive function considered jointly, but not separately.
authors.affiliation: Jagiellonian University Medical College, Faculty of Medicine, 12 Św. Anny Street, 31-008 Kraków, Poland.
authors.forename: Paweł
authors.initials: P
authors.lastname: Matusik
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Tomaszewski
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Chmielowska
authors.forename: Jan
authors.initials: J
authors.lastname: Nowak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Nowak
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Parnicka
authors.forename: Marzena
authors.initials: M
authors.lastname: Dubiel
authors.forename: Jerzy
authors.initials: J
authors.lastname: Gąsowski
authors.forename: Tomasz
authors.initials: T
authors.lastname: Grodzicki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003072:Cognition Disorders / Q000401:mortality*; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009735:Nursing Homes; D011044:Poland / Q000453:epidemiology; D018570:Risk Assessment; D012720:Severity of Illness Index