Table 3.
Performance measures, quality of life, and risk of adverse outcomes of participants in different frailty and cognitive status according to baseline CMMSE total score.a
| Robust |
Pre-frailty |
P/OR(95% CI)† |
|||||
|---|---|---|---|---|---|---|---|
| Outcome | No cognitive impairment(1) (n = 1,703) |
Cognitive impairment(2) (n = 305) |
No cognitive impairment(3) (n = 1,181) |
Cognitive impairment(4) (n = 302) |
(1 vs. 4) | (2 vs. 4) | (3 vs. 4) |
| Physical performance at year 4b | |||||||
| Grip strength, kg | 28.55 ± 7.99 | 24.96 ± 7.28 | 25.20 ± 7.69 | 22.35 ± 7.03 | 0.013 | 0.749 | 0.286 |
| Gait speed, m/s | 1.00 ± 0.21 | 0.95 ± 0.21 | 0.88 ± 0.23 | 0.84 ± 0.22 | 0.002 | 0.719 | 0.138 |
| Five chair stand, s | 9.75 ± 3.56 | 10.16 ± 3.80 | 11.60 ± 5.87 | 12.20 ± 6.27 | 0.001 | 0.118 | 0.729 |
| Cognitive performance at year 4b | |||||||
| Global cognitive functioning | |||||||
| CMMSE total score | 26.89 ± 2.95 | 24.61 ± 3.95 | 26.31 ± 3.20 | 24.93 ± 4.06 | 0.063 | 0.437 | 0.006 |
| Domain-specific cognition | |||||||
| CMMSE time orientation score <5 | 251 (17.19) | 72 (29.27) | 203 (21.99) | 56 (28.00) | 1.09 (0.72, 1.64) | 0.88 (0.53, 1.45) | 1.04 (0.69, 1.56) |
| CMMSE place orientation score <5 | 333 (22.81) | 80 (32.52) | 280 (30.34) | 69 (34.50) | 1.11 (0.76, 1.62) | 1.08 (0.68, 1.71) | 0.99 (0.68, 1.43) |
| CMMSE registration score <3 | 35 (2.40) | 14 (5.69) | 37 (4.01) | 9 (4.50) | 1.55 (0.65, 3.68) | 0.91 (0.34, 2.44) | 1.35 (0.62, 2.96) |
| CMMSE attention/calculation score <5 | 572 (39.18) | 156 (63.41) | 401 (43.45) | 115 (57.50) | 1.04 (0.71, 1.54) | 0.70 (0.44, 1.13) | 0.91 (0.61, 1.36) |
| CMMSE delayed recall score <3 | 537 (36.78) | 117 (47.56) | 373 (40.41) | 104 (52.00) | 1.63 (1.17, 2.28) | 1.39 (0.91, 2.14) | 1.54 (1.10, 2.17) |
| CMMSE language and praxis score <9 | 780 (53.42) | 166 (67.48) | 573 (62.08) | 134 (67.00) | 1.33 (0.92, 1.92) | 1.05 (0.66, 1.66) | 1.08 (0.75, 1.57) |
| Adverse outcomes at year 4–12b | |||||||
| Poor quality of life (SF-12 PCS) at year 4 | 328 (22.47) | 60 (24.39) | 302 (32.72) | 70 (35.00) | 1.53 (1.06, 2.22) | 1.39 (0.84, 2.29) | 1.09 (0.76, 1.57) |
| Poor quality of life (SF-12 MCS) at year 4 | 279 (19.11) | 46 (18.70) | 207 (22.43) | 58 (29.00) | 1.28 (0.86, 1.91) | 1.29 (0.75, 2.21) | 1.33 (0.90, 1.95) |
| Incident physical limitation at year 4 | 374 (25.62) | 76 (30.89) | 332 (35.97) | 86 (43.00) | 1.78 (1.26, 2.51) | 1.78 (1.13, 2.82) | 1.23 (0.87, 1.72) |
| Increased cumulative hospital stay at year 7 | 278 (16.32) | 49 (16.12) | 306 (25.91) | 75 (24.83) | 1.48 (1.06, 2.06) | 1.53 (0.96, 2.44) | 1.06 (0.77, 1.46) |
| Mortality over an average of 12 years | 232 (13.62) | 44 (14.43) | 261 (22.10) | 71 (23.51) | 1.46 (1.02, 2.07) | 1.55 (0.94, 2.54) | 1.19 (0.85, 1.67) |
Data are reported as either number (percentage) or mean ± SD.
aCognitive impairment was defined by CMMSE total score <21 (no education), <24 (primary school), or <27 (secondary school and above).
bAnalyses were based on valid cases observed for grip strength (n = 2,798), gait speed (n = 2,821), five chair stand (n = 2,789), CMMSE, SF-12 and incident physical limitation (n = 2,829), increased cumulative hospital stay (n = 3,490), and mortality (n = 3,491).
†P-values/ORs (95% CI) were obtained from multivariate linear regression/logistic regression adjusting for age, sex, education (below secondary vs. secondary or above), social economic status ladder—Hong Kong (≤4 vs. >4), smoking (current smokers vs. non-current smokers), alcohol intake (>12 vs. ≤12 alcoholic drinks in past 12 m), physical activity (PASE total score), dietary intakes (DQI-I), BMI, and baseline value of respective outcome variable (when appropriate).
CMMSE, Cantonese Mini-Mental Status Examination; DQI-I, Diet Quality Index-International; PASE, Physical Activity Scale of the Elderly; BMI, body mass index.