Abstract
Background
Recently, there is a concern on cognitive frailty, as a potent risk factors for dementia, functional disability, poor quality of life and mortality among elderly. Cognitive frailty is a reversible pathological transitional stage between healthy aging and disability; it is associated with increased health care utilization and co-morbidities. The study purpose was to identify socio-demographic characteristics, co-morbidities, and out-of-pocket payments for health care among elderly Malaysians with cognitive frailty.
Methods
The study included all participants of the third phase of Malaysian representative LRGS-TUA community based study. Multiple types of data were collected through a structured interviewed questionnaire including Fried’s test; Clinical dementia rating test; inpatient and outpatient health care utilization and amount paid.
Results
A total of 1,006 participants were interviewed, with 66.18% response rate. Only 730 respondents found satisfying the inclusion criteria of not having physical disability or psychiatric problem, not terminally ill, and no history of alcohol or drugs abuse. The prevalence of cognitive frailty was 4.5%. Males represented 66.6%. Hypertension, high cholesterol level, joint pain, diabetes mellitus, and vision problems, were the most common chronic diseases among cognitive frail elderly in Malaysia (69.7%, 66.7%, 48.5%, 39.4% and 39.4%, respectively). During last six months, cognitive frailty participants utilized outpatient care at governmental clinic, governmental hospitals, and private clinics (60.6%, 21.2%, and 21.2%, respectively). Out of the cognitive frail patients, only 3.0% were admitted to hospitals during last year. Around half (53%) of the study participants were spending less than RM100 per six months for health care out of their pockets, while 26%, 13%, 8% of the study participants were spending RM101 to RM200, RM201 to RM300, and > RM300 every six months out of their pockets for seeking of care, respectively. The mean total out-of-pocket payments for six months seeking of care for elderly Malaysian citizens with cognitive frailty was around RM84 (SD = 96.0) per six months.
Conclusions
Cognitive frailty is not a costly phenomena among elderly Malaysian citizens. Elderly Malaysians with cognitive frailty are probably characterized with good health and well controlled co-morbidities.