Frailty and cognitive impairment as predictors of mortality in older Mexican Americans.
OBJECTIVE
Examine the association between frailty and cognitive impairment as predictors of mortality over a 10-year period in a selected sample of older Mexican Americans.


METHODS
Longitudinal analyses using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (1995-96/2004-05).


METHODS
Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California.


METHODS
Mexican Americans aged 67 and older with complete information on the frailty index and the Mini Mental State Examination (MMSE) (n=1,815).


METHODS
Cognitive impairment determined by a score in the MMSE < 21. Frailty defined as three or more of the following components: 1) weight-loss, 2) weakness, 3) self-reported exhaustion, 4) slow walking speed, and 5) low physical activity level. Sociodemographic characteristics and chronic medical conditions were used as covariates. Mortality was determined using the National Death Index or by proxy.


RESULTS
As MMSE score declines over time, the percent of frail individuals increases in a linear fashion. Frailty and cognitive impairment are independent risk factors for mortality after controlling for all covariates (HR 2.03 95% CI 1.57-2.62; HR 1.26 95% CI 1.05-1.52, respectively). When both cognitive impairment and frailty were added to the model, HR for individuals with cognitive impairment was no longer statistically significant.


CONCLUSIONS
The relation between frailty and cognitive impairment needs careful analysis in this population to establish pathways increasing mortality and decreasing quality of life. Our results suggest frailty is a stronger predictor of mortality for older Mexican Americans than cognitive impairment.
Institute on Aging, Javeriana University, Bogotá, Colombia.
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Cano
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Samper-Ternent
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Al Snih
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Markides
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Ottenbacher
D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000401:mortality*; D005260:Female; D016330:Frail Elderly / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017058:Mexican Americans / Q000523:psychology / Q000706:statistics & numerical data; D009026:Mortality / Q000208:ethnology / Q000639:trends; D011237:Predictive Value of Tests; D011788:Quality of Life; D012307:Risk Factors