Influencing factors and prevention strategies of cognitive frailty in hospitalized elderly patients
Objective To explore the factors influencing cognitive frailty and its prevention strategies in elderly inpatients.Methods Nine hundred and twenty elderly patients hospitalized in Department of Geriatrics,the First Affiliated Hospital of Xinjiang Medical University from January to December 2022 were selected as the study subjects.General clinical data questionnaire,Clinical Dementia Rating(CDR)Scale and Frail Scale(FS)were used to collect the clinical data of the hospitalized elderly patients in Department of Geriatrics,and then the status quo of cognitive frailty in the elderly patients was assessed.Multivariate logistic regression analysis was used to identify the risk factors of cognitive frailty in the hospitalized elderly patients,and a risk factor model was established.Receiver operating characteristics(ROC)curve was drawn to analyze the predictive value of the risk factor model for cognitive frailty in the hospitalized elderly patients.Results Among the 920 elderly inpatients,45 had cognitive frailty,with the incidence rate being 4.89％.Multivariate logistic regression analysis revealed that older age(OR=2.050,95％CI:1.337-3.143),doing exercise＜3 times per week(OR=2.394,95％CI:1.378-4.161),comorbidities(OR=2.342,95％CI:1.296-4.233),depression(OR=1.931,95％CI:1.312-2.841),malnutrition(OR=2.370,95％CI:1.256-4.473)and having a high level of hemoglobin(OR=0.486,95％CI:0.297-0.797)were independent affecting factors for cognitive frailty in the hospitalized elderly patients(P＜0.05).The regression model was constructed:logit(P)=-12.024+old age×0.718+doing exercise＜3 times per week×0.873+comorbidities ×0.851+depression×0.658+malnutrition×0.863+having a high level of hemoglobin×-0.721.According to the diagnostic probability logit(P),the ROC curve for predicting cognitive frailty in the hospitalized elderly patients was drawn.When logit(P)was＞13,the AUC value,sensitivity and specificity were 0.876,73.33％and 86.86％respectively.Conclusion The hospitalized elderly patients have risks for cognitive frailty.The factors influencing cognitive frailty in the hospitalized elderly patients include old age,doing exercise＜3 times per week,comorbidities,depression,malnutrition and having a high level of hemoglobin,and the predictive model established based on the above-mentioned factors has a high forecasting value.It is necessary to conduct targeted prevention and treatment for the hospitalized elderly patients with high-risk factors for cognitive frailty in clinical practice so as to reduce the risk of occurrence of cognitive frailty.
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