[Relationship between geratic frailty and cognitive dysfunction in the eldly]

Objective: To analyze the current situation and correlation between frailty and cognitive dysfunction in the old patients of orthopedic emergency.

Methods: Enrolling 248 elderly people( ≥65 years old) in orthopedic emergency department of Beijing Jishuitan Hospital from September to December 2018, the cognitive function of the subjects was assessed by Mini-mental State Examination( MMSE). The frailty situation was assessed by FRAIL Scale. In addition, ADL, exercise tolerance assessment, gripping power and geriatric nutritional risk index( GNRI) were also tested in this study.

Results: In this research, 58( 23. 4%) were the elderly with normal cognitive function, 69( 27. 8%) were MCI, and 86( 34. 7%) were dementia and 35( 14. 1%) were severe dementia. The prevalence of seniors over 76 years old was significantly higher than that of the younger age group( χ~2= 39. 300, P < 0. 001), the prevalence of seniors below primary school was significantly higher than that of junior middle school and above( χ~2= 117. 082, P<0. 001), and the prevalence of dementia in patients with chronic obstructive pulmonary disease( COPD) was higher( χ~2= 11. 685, P = 0. 009). The study subjects were strong elderly, accounting for 69( 27. 8%), 114( 46. 0%) and 65( 26. 2%)were in prefrailty and frailty. The prevalence of prefrailty in 75-85 years old people was significantly higher than that in other groups, and the prevalence of prefrailty and frailty in85 years old people was both higher( χ~2= 45. 247, P<0. 001). In addition, education level( χ~2= 13. 909, P = 0. 008), hypertension( χ~2= 6. 892, P = 0. 032), COPD( χ~2= 8. 411, P =0. 015), cerebral infarction( χ~2= 7. 477, P = 0. 024) and GNRI( χ~2= 22. 942, P = 0. 001)were all the influencing factors of frailty. There were also significant differences in ADL, exercise tolerance and gripping power among the above factors. There were significant differences in cognitive function among subjects with different levels of frailty( χ~2=61. 259, P = 0. 000), ADL( χ~2= 54. 652, P<0. 001), exercise tolerance( χ~2= 77. 001, P =0. 000) and grip strength( χ~2= 54. 778, P < 0. 001). After adjusting for demographic characteristics and chronic diseases such as age, sex, education, BMI, coronary heart disease, hypertension and et al. Logistic regression analysis showed that the OR values of prefrailty, frailty, ADL and exercise tolerance affect cognition are 1. 918( 95% CI 0. 990-3. 716), 2. 732( 95%CI 1. 063-7. 023), 3. 217( 95% CI 1. 421-7. 285), 6. 440( 95% CI1. 803-22. 997).

Conclusion: Prefrailty and frailty are closely related to cognitive dysfunction in the elderly.