Prevalence and Factors Associated with Frailty and Cognitive Frailty Among Community-Dwelling Elderly with Knee Osteoarthritis

  • Kulthanit Wanaratna
  • Weerasak MuangpaisanEmail author
  • Vilai Kuptniratsaikul
  • Chalobol Chalermsri
  • Apiwan Nuttamonwarakul
Original Paper


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.


Frailty 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.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Preventive and Social Medicine, Faculty of Medicine, Siriraj HospitalMahidol UniversityBangkokThailand
  2. 2.Department of Thai Traditional and Alternative MedicineMinistry of Public HealthMueang Nonthaburi District, NonthaburiThailand
  3. 3.Department of Rehabilitation Medicine, Faculty of Medicine, Siriraj HospitalMahidol UniversityBangkokThailand
  4. 4.Department of Medical ServicesMinistry of Public HealthMueang Nonthaburi DistrictThailand

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