Prevalence of Frailty and its Association with Cognitive Status and Functional Fitness among Ambulating Older Adults Residing in Institutions within West Coast of Peninsular Malaysia

Abstract

Aim: There is limited information about the association between frailty, cognitive status and functional fitness in older adults living in institutions. We aimed to determine the prevalence of frailty and its association with cognitive status and functional fitness among pre-frail and frail Malaysian older adults residing in institutions on the west coast of Peninsular Malaysia. Methods: This study included 302 ambulating Malaysian institutionalised older adults. Frailty was identified using Fried’s frailty criteria. Cognitive status was assessed using the Mini Mental State Examination and Addenbrooke’s Cognitive Examination. Functional fitness was assessed using the Senior Fitness test. The association between frailty groups, cognitive status and functional fitness was analysed using binary logistic regression. Results: Prevalence of frailty, prefrailty and robustness in the older adults was 56.6%, 40.7% and 2.9%, respectively. Frailty was found to be associated with hypertension (OR 2.15, 95% CI: 1.11–4.16, p = 0.024), lower cognitive status (Addenbrooke’s Cognitive Examination) (OR 0.98, 95% C.I: 0.96–0.99, p = 0.038), and lower dynamic balance and mobility (Timed Up and Go test) (OR 1.09, 95% CI: 1.01–1.16, p = 0.024). Conclusion: Frailty is highly prevalent among Malaysian institutionalised older adults. Hypertension, cognitive impairment and lower dynamic balance and mobility were found to be risk factors of frailty. Screening of frailty and its associated factors should be prioritized among institutionalised older adults in view of early prevention and rehabilitation.

Comprehensive Model for Physical and Cognitive Frailty: Current Organization and Unmet Needs

“…Frailty is a highly prevalent condition worldwide. For example, in a Malaysian over 60 institutionalized population, the prevalence of physical frailty and prefrailty was 56.6 and 40.7%, respectively (Murukesu et al, 2019). In the same country, in a community setting, the prevalence of cognitive frailty was 2.2%, while the prefrail persons were the 37.4% (Malek Rivan et al, 2019).…”

Physical Activity Patterns, Psychosocial Well-Being and Coping Strategies Among Older Persons with Cognitive Frailty of the “WE-RISE” Trial Throughout the COVID-19 Movement Control Order

“…Physical frailty was found to be highly prevalent at 56.6% among Malaysian older persons residing in institutions and has been strongly associated with cognitive decline. 21 Within the community-dwelling population, cognitive frailty has been reported to be prevalent at 2.2%. 22 Among the significant predictors of this potentially debilitating condition are depression, decline in functional mobility, physical frailty and increasing age.…”

Multidomain Intervention for Reversal of Cognitive Frailty, Towards a Personalized Approach (AGELESS Trial): Study Design

“…Non-permanent residents and those who resided less than 6 months in a particular study site will be excluded. Participants will have to meet the following inclusion criteria in order to be recruited in the RCT; MMSE ≥19 and < 26 points [ 46 ], Clinical Dementia Rating Scale (CDR) = 0.5 [ 13 ] and fulfils at least three of Fried’s frailty criteria [ 3 ]. Exclusion criteria include those conditions that affects engagement in the interventions such as major depression, dementia, other major psychiatric disorders, severe cognitive impairment, malignant diseases or other conditions preventing safe participation and cooperation as judged by the study staff and coincident participation in any intervention trial.…”

“…Noteworthy, these mechanisms also act as catalyst in cognitive decline and dementia due to neurodegenerative and vascular damages [ 12 ]. In Malaysia, the co-existence of both physical frailty and cognitive impairment has been demonstrated to be high among institutionalized older adults [ 13 ].…”