Physiological indexes, psychological resilience, sensory functions, and sleep quality on the cognitive function of older adults with pre-frailty: a predictive study

Population ageing has increased the prevalence of prefrailty comorbid with cognitive impairment among older adults. However, few studies have explored the risk factors common to both prefrailty and cognitive impairment. This study determined the predictive accuracy of demographic characteristics, physiological indexes, psycho-logical resilience, sensory function, and sleep quality on the cognitive function of older adults with prefrailty. In this cross-sectional study, the physiological indexes, psychological resilience, sensory function, sleep quality, and cognitive function of 167 community-dwelling older adults with prefrailty recruited through purposive sampling were measured. SPSS software was used for data coding and compilation. Data analysis involved the use of descriptive statistics, the independent samples t test, the chi-square test, and logistic regression. Overall, in cognitive function, there was no difference in gender but were in age, were incapable of text messaging, had a greater number of chronic diseases, were less able to perform activities of daily living, had low psychological resilience, and had depressive tendencies. In addition, Text messaging capability and depression status can all predict the cognitive impairment state of prefrail older elderly. Physiological indexes, psychological resilience, sensory function, and sleep quality can affect cognitive function in older adults with prefrailty. Meanwhile, depressive tendencies and the inability to send text messages on a mobile device constituted critical predictors of cognitive function in the participants.

Prefrailty; Physiological index; Psychological resilience; Sensory function; Sleep quality; Cognitive status

[1] Kim HJ, Min KB, Min JY. Healthy aging predicts mortality risks: Results from the Korean longitudinal study of aging (2006–2014). Archives of Gerontology and Geriatrics. 2021; 94: 104333.

[2] Burns DK, Alexander RC, Welsh-Bohmer KA, Culp M, Chiang C, O’Neil J, et al. Safety and efficacy of pioglitazone for the delay of cognitive impairment in people at risk of Alzheimer’s disease (TOMMORROW): a prognostic biomarker study and a phase 3, randomised, double-blind, placebo-controlled trial. The Lancet Neurology. 2021; 20: 537–547.

[3] Chang S, Lin P. Frail phenotype and mortality prediction: a systematic review and meta-analysis of prospective cohort studies. International Journal of Nursing Studies. 2015; 52: 1362–1374.

[4] Ensrud KE, Ewing SK, Taylor BC, Fink HA, Cawthon PM, Stone KL, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Archives of Internal Medicine. 2008; 168: 382–389.

[5] Luciani A, Ascione G, Bertuzzi C, Marussi D, Codecà C, Di Maria G, et al. Detecting disabilities in older patients with cancer: comparison between comprehensive geriatric assessment and vulnerable elders survey-13. Journal of Clinical Oncology. 2010; 28: 2046–2050.

[6] Hu B, Hsiao-Wei Y, Chiu T, Li-Ling L, Chen Y. The validity of the study of osteoporotic fractures (SOF) index for assessing community-based older adults in Taiwan. Innovation in Aging. 2018; 2: 1015.

[7] Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing. 2005; 14: 798–804.

[8] Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. Journal of Pain Research. 2018; 11: 851–856.

[9] Lee MS, Lin SL, Lui CM. The study of validity and reliability of four simple self-reported questionnaire on physical activity—using RT3 Tri-axial accelerometer as criterion. Journal of Health Promotion and Health Education. 2002; 17: 1–14.

[10] Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist. 1969; 9: 179–186.

[11] Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the lawton instrumental activities of daily living scale to Turkish: validity and reliability study. Annals of Geriatric Medicine and Research. 2020; 24: 35–40.

[12] Friborg O, Hjemdal O, Rosenvinge JH, Martinussen M, Aslaksen PM, Flaten MA. Resilience as a moderator of pain and stress. Journal of Psychosomatic Research. 2006; 61: 213–219.

[13] Sheikh JI, Yesavage JA. Geriatric depression scale (GDS) recent evidence and development of a shorter version. Clinical Gerontologist. 1986; 5: 165–173.

[14] Chiu CJ, Chen YT, Huang HM, Lin YH. The construction of disability process database in Taiwan. Journal of Health Science. 2018; 1–10.

[15] Nondahl DM, Cruickshanks KJ, Wiley TL, Tweed TS, Klein R, Klein BEK. Accuracy of self-reported hearing loss. International Journal of Audiology. 1998; 37: 295–301.

[16] Sindhusake D, Mitchell P, Smith W, Golding M, Newall P, Hartley D, et al. Validation of self-reported hearing loss. The blue mountains hearing study. International Journal of Epidemiology. 2001; 30: 1371–1378.

[17] Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Research. 1989; 28: 193–213.

[18] Galvin JE, Roe CM, Powlishta KK, Coats MA, Muich SJ, Grant E, et al. The AD8: a brief informant interview to detect dementia. Neurology. 2005; 65: 559–564.

[19] Yang Y, Galvin JE, Morris JC, Lai C, Chou M, Liu C. Application of AD8 questionnaire to screen very mild dementia in Taiwanese. American Journal of Alzheimer’s Disease and other Dementiasr. 2011; 26: 134–138.

[20] Yang WT, Lu CY, Chen SC, Chien KY. The relationship between walking speed and functional fitness in the non- frailty and pre- frailty elderly. International Journal of Sports Physiology and Performance. 2018; 5: 89–96.

[21] Tang TC, Hwang AC, Liu LK, Lee WJ, Chen LY, Wu YH, et al. FNIH-defined sarcopenia predicts adverse outcomes among community-dwelling older people in Taiwan: results from I-Lan longitudinal aging study. The Journals of Gerontology: Series A. 2018; 73: 828–834.

[22] Nakai Y, Makizako H, Kiyama R, Tomioka K, Taniguchi Y, Kubozono T, et al. Association between chronic pain and physical frailty in community-dwelling older adults. International Journal of Environmental Research and Public Health. 2019; 16: 1330.

[23] Chen YH, Chang SP. Investigation of relationship between sleep duration and body mass index. Journal of Sport and Recreation Researches. 2012; 7: 68–78.

[24] Song, Dan, S. F. Doris. Effects of a moderate-intensity aerobic exercise programme on the cognitive function and quality of life of community-dwelling elderly people with mild cognitive impairment: a randomised controlled trial. International journal of nursing studies. 2019; 93: 97–105.

[25] Robertson DA, Savva GM, Coen RF, Kenny R. Cognitive function in the prefrailty and frailty syndrome. Journal of the American Geriatrics Society. 2014; 62: 2118–2124.

[26] Turner Goins R, Schure M, Winchester B. Frailty in older american indians: the native elder care study. Gerontology and Geriatric Medicine. 2019; 5: 2333721419855669.

[27] Navabi N, Ghaffari F, Jannat-Alipoor Z. Older adults’ attitudes and barriers toward the use of mobile phones. Clinical Interventions in Aging. 2016; 11: 1371–1378.

[28] Weng CF, Lin KP, Chan DC. Geriatric depression and cognitive impairment. Journal of Internal Medicine of Taiwan. 2014; 25: 158–164.

[29] Liu X, Chiou CJ. The resilience of elderly residents in long-term care facilities and related factors. Journal of Nursing & Healthcare Research. 2012; 8: 179–190.

[30] MA XQ, Jiang CQ, Xu L, Zhang WS, Zhu F, Jin YL, et al. Sleep quality and cognitive impairment in older Chinese: Guangzhou biobank cohort study. Age and Ageing. 2019; 49: 119–124.

[31] Almeida OP, Yeap BB, Alfonso H, Hankey GJ, Flicker L, Norman PE. Older men who use computers have lower risk of dementia. PLoS ONE. 2012; 7: e44239.

[32] Albala C, Lera L, Sanchez H, Angel B, Márquez C, Arroyo P, et al. Frequency of frailty and its association with cognitive status and survival in older Chileans. Clinical Interventions in Aging. 2017; 12: 995–1001.

[33] Chu X, Zhang N, Shi G, Wang Y, Wang Z, Guo J, et al. Frailty and incident depressive symptoms in a Chinese sample: the Rugao longevity and ageing study. Psychogeriatrics. 2020; 20: 691–698.

[34] Zhang SM, Tang XD, Yang XR, Zheng RR, Xu L, Wu JH. Relationship between frailty and depression in elderly patients. Zhonghua Yi Xue Za Zhi. 2017; 2017: 3384–3387. (In Chinese)

[35] Buchner DM, Wagner EH. Preventing frail health. Clinics in Geriatric Medicine. 1992; 8: 1–17.

[36] Cable N, Hiyoshi A, Kondo N, Aida J, Sjöqvist H, Kondo K. Identifying frail-related biomarkers among community-dwelling older adults in Japan: a research example from the Japanese gerontological evaluation study. BioMed Research International. 2018; 2018: 5362948.

[37] Downer B, Al Snih S, Howrey BT, Raji MA, Markides KS, Ottenbacher KJ. Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans. Aging and Mental Health. 2019; 23: 1405–1412.

[38] Freitag S, Schmidt S. Psychosocial correlates of frailty in older adults. Geriatrics. 2016; 1: 26.

[39] Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2004; 59: M255–M263.

[40] Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. The Journals of Gerontology Series a: Biological Sciences and Medical Sciences. 2001; 56: M146–M157.

[41] Gifford KA, Bell SP, Liu D, Neal JE, Turchan M, Shah AS, et al. Frailty is related to subjective cognitive decline in older women without dementia. Journal of the American Geriatrics Society. 2019; 67: 1803–1811.

[42] Hsieh CC, Hsiao YY, Lin MC, Chen BC. Frailty elderly. Journal of Family Medicine and Primary Care. 2010; 25: 410–417.

[43] Moreno-Tamayo K, Ramírez-García E, Sánchez-García S. Sleep disturbances are associated with frailty in older adults. Revista Medica del Instituto Mexicano del Seguro Social. 2018; 56: S38–S44. (In Spanish)

[44] Yan ZX, Hsieh MF. Frailty of the elderly. Medicine Today. 2013; 473: 167–173.