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Synergistic effects of cognitive frailty and comorbidities on disability: a community-based longitudinal study

الآثار التآزرية للضعف المعرفي والأمراض المصاحبة على الإعاقة: دراسة طولية مجتمعية
Authors: Nurul Fatin Malek Rivan; Resshaya Roobini Murukesu; Suzana Shahar; Nor Fadilah Rajab; Ponnusamy Subramaniam; T. Ooi; Mohd Zul Amin Kamaruddin; +1 Authors

Synergistic effects of cognitive frailty and comorbidities on disability: a community-based longitudinal study

Abstract

Abstract Objective In this study, we aimed to assess the synergistic effects of cognitive frailty (CF) and comorbidity on disability among older adults. Methods Out of the 1318 participants from the Malaysian Towards Useful Aging (TUA) study, only 400 were included in the five-year follow-up analysis. A comprehensive interview-based questionnaire covering socio-demographic information, health status, biochemical indices, cognitive and physical function, and psychosocial factors was administered. Binary logistic regression analysis was employed to estimate the independent and combined odd ratios (ORs). Measures such as the relative excess risk due to interaction (RERI), the attributable proportion of risk due to the interaction, and the synergy index were used to assess the interaction between CF and comorbidity. Results Participants with CF (24.1%) were more likely to report disability compared to those without CF (10.3%). Synergistic effects impacting disability were observed between CF and osteoarthritis (OA) (OR: 6.675, 95% CI: 1.057–42.158; RERI: 1.501, 95% CI: 1.400–1.570), CF and heart diseases (HD) (OR: 3.480, 95% CI: 1.378–8.786; RERI: 0.875, 95% CI: 0.831–0.919), CF and depressive symptoms (OR: 3.443, 95% CI: 1.065–11.126; RERI: 0.806, 95% CI: 0.753–0.859), and between CF and diabetes mellitus (DM) (OR: 2.904, 95% Confidence Interval (CI): 1.487–5.671; RERI: 0.607, 95% CI: 0.577–0.637). Conclusion These findings highlight the synergism between the co-existence of CF and comorbidity, including OA, HD, DM, and depressive symptoms, on disability in older adults. Screening, assessing, and managing comorbidities, especially OA, HD, DM and depressive symptoms, when managing older adults with CF are crucial for reducing the risk of or preventing the development of disability.

Keywords

Male, Persons with Disabilities, Physiology, Social Sciences, Logistic regression, Comorbidity, Disability Evaluation, Diabetes mellitus, Endocrinology, Pathology, Female [MeSH] ; Cognitive Dysfunction/epidemiology [MeSH] ; Cognitive frailty ; Aged, 80 and over [MeSH] ; Morbidity ; Aged [MeSH] ; Disability ; Humans [MeSH] ; Malaysia/epidemiology [MeSH] ; Longitudinal Studies [MeSH] ; Middle Aged [MeSH] ; Synergism ; Cognitive Dysfunction/psychology [MeSH] ; Male [MeSH] ; Disabled Persons/psychology [MeSH] ; Frailty/epidemiology [MeSH] ; Older adults ; Research ; Comorbidity [MeSH] ; Frailty/psychology [MeSH] ; Disability Evaluation [MeSH] ; Frail Elderly/psychology [MeSH], Longitudinal Studies, Internal medicine, Aged, 80 and over, Psychiatry, Frailty, Comprehensive Geriatric Assessment, Odds ratio, Middle Aged, Economics, Econometrics and Finance, Older adults, Medicine, Female, Longitudinal study, Psychosocial, Economics and Econometrics, Frail Elderly, Research ; Cognitive frailty ; Morbidity ; Synergism ; Disability ; Older adults, Frailty in Older Adults and Geriatric Care, Health Sciences, Absolute risk reduction, Humans, Cognitive Dysfunction, Sarcopenia: Definition, Diagnosis, and Implications, Aged, Health and Retirement Study, Disability, Cognitive frailty, Research, Confidence interval, Synergism, RC952-954.6, Malaysia, Health Economics and Quality of Life Assessment, Geriatrics, FOS: Biological sciences, Morbidity, Geriatrics and Gerontology, Gerontology, ddc: ddc:

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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