Trajectories of Frailty and Cognitive Decline Among Older Mexican Americans.
Aged
Arthritis
/ epidemiology
Cognitive Dysfunction
/ epidemiology
Diabetes Mellitus
/ epidemiology
Disease Progression
Educational Status
Female
Follow-Up Studies
Frailty
/ epidemiology
Humans
Hypertension
/ epidemiology
Leisure Activities
Male
Mexican Americans
Neuropsychological Tests
Obesity
/ epidemiology
Overweight
/ epidemiology
Religion
Southwestern United States
/ epidemiology
Walking Speed
Hispanic
Physical function
Transition
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
13 07 2020
13 07 2020
Historique:
received:
10
04
2019
pubmed:
6
2
2020
medline:
11
2
2021
entrez:
4
2
2020
Statut:
ppublish
Résumé
Progressive physical frailty and cognitive decline in older adults is associated with increased risk of falls, disability, institutionalization, and mortality; however, there is considerable heterogeneity in progression over time. We identified heterogeneous frailty and cognitive decline trajectory groups and examined the specific contribution of health conditions to these trajectories among older Mexican origin adults. We use a sample from the Hispanic Established Population for the Epidemiological Study of the Elderly (HEPESE) with at least two measures of frailty criteria during 18 years follow-up: slow gait, weak handgrip strength, exhaustion, and unexplained weight loss (n = 1362, mean age 72). Cognition was measured using the Mini-Mental State Examination (MMSE). Using group-based trajectory models we identified three frailty groups-non-frail (n = 331), moderate progressive (n = 855), and progressive high (n = 149)-and three cognitive decline groups-non-cognitively impaired (476), moderate decline (677) and rapid decline (n = 209). The probability of membership in a high-frailty group given membership in a progressive cognitive decline group was 63%, while the probability of being in a non-frail group given membership in a non-cognitively impaired group was 68%. Predictors of membership into both the progressive high frailty and rapid cognitive decline groups combined were low education and diabetes. Weekly church attendance was associated with a 66% reduction in the odds of being in the combined groups. Interventions to reduce frailty rates and cognitive decline might focus on the management of underlying chronic disease and on increasing participation in activities outside the home.
Sections du résumé
BACKGROUND
Progressive physical frailty and cognitive decline in older adults is associated with increased risk of falls, disability, institutionalization, and mortality; however, there is considerable heterogeneity in progression over time. We identified heterogeneous frailty and cognitive decline trajectory groups and examined the specific contribution of health conditions to these trajectories among older Mexican origin adults.
METHODS
We use a sample from the Hispanic Established Population for the Epidemiological Study of the Elderly (HEPESE) with at least two measures of frailty criteria during 18 years follow-up: slow gait, weak handgrip strength, exhaustion, and unexplained weight loss (n = 1362, mean age 72). Cognition was measured using the Mini-Mental State Examination (MMSE).
RESULTS
Using group-based trajectory models we identified three frailty groups-non-frail (n = 331), moderate progressive (n = 855), and progressive high (n = 149)-and three cognitive decline groups-non-cognitively impaired (476), moderate decline (677) and rapid decline (n = 209). The probability of membership in a high-frailty group given membership in a progressive cognitive decline group was 63%, while the probability of being in a non-frail group given membership in a non-cognitively impaired group was 68%. Predictors of membership into both the progressive high frailty and rapid cognitive decline groups combined were low education and diabetes. Weekly church attendance was associated with a 66% reduction in the odds of being in the combined groups.
CONCLUSIONS
Interventions to reduce frailty rates and cognitive decline might focus on the management of underlying chronic disease and on increasing participation in activities outside the home.
Identifiants
pubmed: 32012218
pii: 5721732
doi: 10.1093/gerona/glz295
pmc: PMC7357582
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1551-1557Subventions
Organisme : NIMHD NIH HHS
ID : R01 MD010355
Pays : United States
Informations de copyright
© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
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