Prevalence and Factors Associated with Frailty and Cognitive Frailty Among Community-Dwelling Elderly with Knee Osteoarthritis
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Physical frailty and cognitive impairment are risk factors for adverse outcomes in older people with osteoarthritis of the knee (knee OA). This cross-sectional study was conducted to determine the prevalence and associated factors of frailty and cognitive frailty among community-dwelling older patients with knee OA in four representative cities of Thailand. Data composed of three parts, Part 1: Demographic data, Part 2: The assessment of frailty by Fried phenotype and cognitive function by MiniCog and Part 3: The assessment of factors associated with frailty. Of 780 elders (mean age, 69.4 ± 6.9 years) screened, 101 (12.9%) were classified to be frail, 511 (65.6%) pre-frail and 168 (21.5%) non-frail. The prevalence of cognitive frailty was 2.44%. The correlation between physical activity rated by the Global Physical Activity Questionnaire (GPAQ) and self-rated methods was high (kappa 0.721; p < 0.001). Self-rated physical activity yielded similar prevalence of frail (9.4%), pre-frail (69.1%) and non-frail (21.5%). In multivariate analysis, aging (OR 3.42; 95% CI 1.16–10.11), severe knee OA symptoms (OR 18.96; 95% CI 3.53–101.65), malnutrition (OR 2.50; 95% CI 1.23–5.09), and functional dependence (OR 3.94; 95% CI 1.19–13.03) were associated with frailty. The prevalence of frailty and pre-frailty was high in knee OA and associated with aging, severe knee OA symptoms, malnutrition, and functional dependence, whereas the prevalence of cognitive frailty was not uncommon in community-dwelling elderly. Physical activity rated by the GPAQ and self-rated methods were highly correlated. Self-rated physical activity may be used in community surveys of frailty.
KeywordsFrailty Osteoarthritis Older Cognitive Physical activity
The authors would like to thank Mrs. Angkana Jongsawaddipatana and all staff members of Institute of Geriatric Medicine, Department of Medical Service, Ministry of Public Health for their collaboration in collecting data.
This work was financially supported by the His Royal Highness Princess Chainat Narenthorn Foundation. The funder had no role in the study design, data collection or analysis, writing of the report, or the decision to publish this article.
Compliance with Ethical Standards
Conflict of interest
The authors declare no conflicts of interest, financial or otherwise.
- 3.Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bulletin of the World Health Organization, 81(9), 646–656.Google Scholar
- 13.Delrieu, J., Andrieu, S., Pahor, M., Cantet, C., Cesari, M., Ousset, P. J.,… Vellas, B. (2016). Neuropsychological Profile of “Cognitive Frailty” Subjects in MAPT Study. Journal of Prevention of Alzheimer’s Disease, 3(3), 151–159.Google Scholar
- 16.World Health Organization. (2007). Global Physical Activity Questionnaire (GPAQ). Geneva:WHO.Google Scholar
- 17.Samahito, S., Bhatharobhas, V., Ruangthai, R., Sriyaphai, A., & Thearnthong, A. (2004). Physical fitness norms for Thai people and Kasetsart University physical fitness analysis program version 1.0. Kasetsart Educational Review, 2, 27–40.Google Scholar
- 21.Charoencholvanich, K., & Pongcharoen, B. (2005). Oxford Knee Score and SF-36: Translation & reliability for use with total knee arthroscopy patients in Thailand. Journal of the Medical Association of Thailand, 88(9), 1194–1202.Google Scholar
- 22.Kaiser, M. J., Bauer, J. M., Ramsch, C., Uter, W., Guigoz, Y., Cederholm, T.,… Sieber, C. C. (2009). Validation of the Mini Nutritional Assessment Short Form (MNA-SF); A practical tool for identification of nutritional status. Journal of Nutrition, Health and Aging, 13, 782–788.CrossRefGoogle Scholar
- 23.Mahoney, F. I., & Barthel, D. W. (1965). Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61–65.Google Scholar
- 27.Misra, D., Felson, D. T., Silliman, R. A., Nevitt, M., Lewis, C. E., Torner, J.,… Neogi, T. (2015). Knee osteoarthritis and frailty: Findings from the Multicenter Osteoarthritis Study and Osteoarthritis Initiative. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 70(3), 339–344.CrossRefGoogle Scholar
- 29.Castell, M. V., van der Pas, S., Otero, A., Siviero, P., Dennison, E., Denkinger, M.,… Deek, D. (2015). Osteoarthritis and frailty in elderly individuals across six European countries: Results from the European Project on OSteoArthritis (EPOSA). BMC Musculoskeletal Disorder, 16, 359.CrossRefGoogle Scholar
- 31.Fried, L. P., Walston, J. D., & Ferrucci, L. (2009). Hazzard’s geriatric medicine and gerontology (6th ed., pp. 631–645). New York: McGraw-Hill.Google Scholar
- 37.Avila-Funes, J. A., Helmer, C., Amieva, H., Barberger-Gateau, P., Le Goff, M., Ritchie, K., … Dartiques, J. F. (2008). Frailty among community-dwelling elderly people in France: The Three-City study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 63(10), 1089–1096.CrossRefGoogle Scholar
- 39.Borson, S., Scanlan, J. M., Chen, P., & Ganguli, M. The Mini-Cog as a screen for dementia: Validation in a population-based sample. Journal of the American Geriatrics Society, 51(10):1451–1454.Google Scholar
- 40.Ngandu, T., Lehtisalo, J., Solomon, A., Levälahti, E., Ahtiluoto, S., Antikainen, R., … Kivipelto, M. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial. Lancet, 385(9984), 2255–2263.CrossRefGoogle Scholar