Associations Between Physical Frailty and Cognitive Functioning Using Factor Analysis

Abstract

While there are several proposed definitions, Fried et al. (2001) is the first study to define the physical characteristics of frailty. To date there have been few attempts to validate this criterion. Further, there is a long-standing and growing interest in the relationship between frailty and cognitive impairment. Few studies have investigated this relationship using an unmodified Fried criterion and cognitive measures beyond a mental status screener. We first examined whether the physical indicators of Fried phenotype cluster together to describe frailty syndrome using confirmatory factor analysis (CFA) and we further explored the association between frailty as a latent variable and as individual indicators with specific cognitive domains. Participants (n=214) were recruited from the University of Miami Memory Disorders Clinic and the Miami community. All participants underwent frailty and comprehensive neuropsychological assessments. A five-factor confirmatory model was tested and latent and multiple regression were used to determine associations between frailty and cognition. We found the five-factor model of frailty fit the data. The frailty latent variable was negatively associated with verbal and visual memory. Walking speed was negatively associated with verbal memory and demonstrated marginal significant association with visual memory. The data support the existence of a latent construct consistent with frailty syndrome. Frailty syndrome was associated with memory dysfunction, but not with other cognitive domains. This contrasts with literature showing more widespread cognitive dysfunction among frail individuals. Understanding the relationship between frailty and memory may encourage clinicians to consider additional screens/referrals, which ultimately will improve caring for older adults.</p