title: Cognitive Frailty and Adverse Health Outcomes: Findings From the Singapore Longitudinal Ageing Studies (SLAS).
abstract: OBJECTIVE
  There is a recent consensus proposal of "cognitive frailty" defined by the presence of both physical frailty and cognitive impairment in the absence of dementia. The relevance, validity, and utilization of cognitive frailty, however, is presently unclear. We determine whether concurrent physical frailty and cognitive impairment, compared with physical frailty alone substantially increased adverse health outcomes (functional disability, hospitalization, poor quality of life [QOL], and mortality).
  
  
  METHODS
  Longitudinal study.
  
  
  METHODS
  Population-based cohort (Singapore Longitudinal Ageing Study, SLAS).
  
  
  METHODS
  Two thousand three hundred seventy-five Chinese Singaporeans aged 55 and above without dementia and degenerative disorders.
  
  
  METHODS
  The associations of physical frailty (Cardiovascular Health Study criteria: 0 = robust, 1-2 = pre-frail, 3-5 = frail) with and without cognitive impairment (mini-mental state examination <26) and adverse outcomes were estimated, controlling for age, gender, education, comorbidity, smoking, alcohol consumption, depressive symptoms, baseline activities of daily living-instrumental and basic activities of daily living disability or QOL score.
  
  
  RESULTS
  Compared to robust noncognitively impaired individuals, physical pre-frailty with cognitive impairment was associated with a twofold increased prevalence and incidence of functional disability, a twofold increased incidence of poor QOL, and 1.8-fold increased mortality risks. Cognitively impaired frail individuals stood out with 12- to 13-fold increased prevalence and incidence of functional disability, a five- and 27-fold increased prevalence and incidence of low QOL, and a fivefold increased mortality risk. The estimated prevalence of physical frailty with cognitive impairment was 1.8%, and physical pre-frailty with cognitive impairment was 8.9%.
  
  
  CONCLUSIONS
  Pre-frailty and frailty with impaired cognitive function, found in 10.7% of this dementia-free population, was associated with an evidently high risk of adverse health outcomes.
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore; Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore.
authors.forename: Liang
authors.initials: L
authors.lastname: Feng
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Ma Shwe
authors.initials: MS
authors.lastname: Zin Nyunt
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Qi
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Lei
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Geriatric Medicine, Alexandra Hospital, Singapore.
authors.forename: Keng Bee
authors.initials: KB
authors.lastname: Yap
authors.affiliation: Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore. Electronic address: pcmngtp@nus.edu.sg.
authors.forename: Tze-Pin
authors.initials: TP
authors.lastname: Ng
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000523:psychology*; D060825:Cognitive Dysfunction; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012846:Singapore
keywords: Frailty; cognitive impairment; functional disability; hospitalization; mortality; quality of life