Cross-lagged analysis of cognitive function and physical frailty changes in elderly residents of nursing homes
Objective To investigate the temporal trends in physical frailty and cognitive function among elderly residents in nursing homes and to analyze the time-series relationship between them.Methods A stratified random sampling was used to select 512 elderly residents in a nursing home in Guangzhou from September to December 2022(T1)and from June to September 2023(T2).The Frailty Phenotype Scale and the Montreal Cognitive Assessment Scale were employed to assess their physical frailty and cognitive function.Repeated measures ANOVA was applied to explore gender differences over time,while Spearman correlation analysis to assess the relationship between frailty and cognitive function.A cross-lagged panel model was constructed using Mplus 8.3 to analyze the bidirectional relationship between the two variables.Results Cognitive function among the elderly in nursing homes showed a declining trend,and frailty scores at both time points were significantly positively correlated.Autoregressive results indicated that frailty significantly predicted future frailty(β=0.567,P<0.001),while cognitive function significantly predicted future cognitive function(β=0.680,P<0.001).The cross-lagged model revealed that cognitive function had a significant negative predictive effect on future frailty(β=-0.146,P=0.002),whereas frailty did not significantly predict future cognitive function(β=0.064,P=0.134).Conclusion Elderly residents in nursing homes with lower cognitive function are more likely to experience future physical frailty,with a continued decline in cognitive function and worsening frailty symptoms.Healthcare professionals should strengthen the monitoring of cognitive function and physical frailty for elderly residents in nursing homes and implement comprehensive care interventions such as cognitive training,physical exercise,and nutritional support to slow the progression of cognitive decline and frailty,thereby promoting healthy aging.
frailtycognitive functioncross-lagged modelnursing homeelderly healthlongitudinal study