Physical frailty and cognitive impairment in older nursing home residents: a latent class analysis

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Abstract

Background: Little is known about the heterogeneous clinical profile of physical frailty and its association with cognitive impairment in older U.S. nursing home (NH) residents. Methods: Minimum Data Set 3.0 at admission was used to identify older adults newly-admitted to nursing homes with life expectancy ≥6 months and length of stay ≥100 days (n = 871,801). Latent class analysis was used to identify physical frailty subgroups, using FRAIL-NH items as indicators. The association between the identified physical frailty subgroups and cognitive impairment (measured by Brief Interview for Mental Status/Cognitive Performance Scale: none/mild; moderate; severe), adjusting for demographic and clinical characteristics, was estimated by multinomial logistic regression and presented in adjusted odds ratios (aOR) and 95% confidence intervals (CIs). Results: In older nursing home residents at admission, three physical frailty subgroups were identified: “mild physical frailty” (prevalence: 7.6%), “moderate physical frailty” (44.5%) and “severe physical frailty” (47.9%). Those in “moderate physical frailty” or “severe physical frailty” had high probabilities of needing assistance in transferring between locations and inability to walk in a room. Residents in “severe physical frailty” also had greater probability of bowel incontinence. Compared to those with none/mild cognitive impairment, older residents with moderate or severe impairment had slightly higher odds of belonging to “moderate physical frailty” [aOR (95%CI)moderate cognitive impairment: 1.01 (0.99–1.03); aOR (95%CI)severe cognitive impairment: 1.03 (1.01–1.05)] and much higher odds to the “severe physical frailty” subgroup [aOR (95%CI)moderate cognitive impairment: 2.41 (2.35–2.47); aOR (95%CI)severe cognitive impairment: 5.74 (5.58–5.90)]. Conclusions: Findings indicate the heterogeneous presentations of physical frailty in older nursing home residents and additional evidence on the interrelationship between physical frailty and cognitive impairment.

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Yuan, Y., Lapane, K. L., Tjia, J., Baek, J., Liu, S. H., & Ulbricht, C. M. (2021). Physical frailty and cognitive impairment in older nursing home residents: a latent class analysis. BMC Geriatrics, 21(1). https://doi.org/10.1186/s12877-021-02433-1

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