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Abstract：
OBJECTIVE: In this study, we aimed to assess the synergistic effects of cognitive frailty (CF) and comorbidity on disability among older adults.
METHODS: Out of the 1318 participants from the Malaysian Towards Useful Aging (TUA) study, only 400 were included in the five-year follow-up analysis. A comprehensive interview-based questionnaire covering socio-demographic information, health status, biochemical indices, cognitive and physical function, and psychosocial factors was administered. Binary logistic regression analysis was employed to estimate the independent and combined odd ratios (ORs). Measures such as the relative excess risk due to interaction (RERI), the attributable proportion of risk due to the interaction, and the synergy index were used to assess the interaction between CF and comorbidity.
RESULTS: Participants with CF (24.1%) were more likely to report disability compared to those without CF (10.3%). Synergistic effects impacting disability were observed between CF and osteoarthritis (OA) (OR: 6.675, 95% CI: 1.057-42.158; RERI: 1.501, 95% CI: 1.400-1.570), CF and heart diseases (HD) (OR: 3.480, 95% CI: 1.378-8.786; RERI: 0.875, 95% CI: 0.831-0.919), CF and depressive symptoms (OR: 3.443, 95% CI: 1.065-11.126; RERI: 0.806, 95% CI: 0.753-0.859), and between CF and diabetes mellitus (DM) (OR: 2.904, 95% Confidence Interval (CI): 1.487-5.671; RERI: 0.607, 95% CI: 0.577-0.637).
CONCLUSIONS: These findings highlight the synergism between the co-existence of CF and comorbidity, including OA, HD, DM, and depressive symptoms, on disability in older adults. Screening, assessing, and managing comorbidities, especially OA, HD, DM and depressive symptoms, when managing older adults with CF are crucial for reducing the risk of or preventing the development of disability.
METHODS: Out of the 1318 participants from the Malaysian Towards Useful Aging (TUA) study, only 400 were included in the five-year follow-up analysis. A comprehensive interview-based questionnaire covering socio-demographic information, health status, biochemical indices, cognitive and physical function, and psychosocial factors was administered. Binary logistic regression analysis was employed to estimate the independent and combined odd ratios (ORs). Measures such as the relative excess risk due to interaction (RERI), the attributable proportion of risk due to the interaction, and the synergy index were used to assess the interaction between CF and comorbidity.
RESULTS: Participants with CF (24.1%) were more likely to report disability compared to those without CF (10.3%). Synergistic effects impacting disability were observed between CF and osteoarthritis (OA) (OR: 6.675, 95% CI: 1.057-42.158; RERI: 1.501, 95% CI: 1.400-1.570), CF and heart diseases (HD) (OR: 3.480, 95% CI: 1.378-8.786; RERI: 0.875, 95% CI: 0.831-0.919), CF and depressive symptoms (OR: 3.443, 95% CI: 1.065-11.126; RERI: 0.806, 95% CI: 0.753-0.859), and between CF and diabetes mellitus (DM) (OR: 2.904, 95% Confidence Interval (CI): 1.487-5.671; RERI: 0.607, 95% CI: 0.577-0.637).
CONCLUSIONS: These findings highlight the synergism between the co-existence of CF and comorbidity, including OA, HD, DM, and depressive symptoms, on disability in older adults. Screening, assessing, and managing comorbidities, especially OA, HD, DM and depressive symptoms, when managing older adults with CF are crucial for reducing the risk of or preventing the development of disability.
摘要：
目的：在本研究中，我们旨在评估认知虚弱(CF)和共病对老年人残疾的协同作用.
方法：在马来西亚迈向有用衰老（TUA）研究的1318名参与者中，5年随访分析中仅纳入400例.一份全面的基于访谈的问卷，涵盖社会人口统计信息，健康状况,生化指标,认知和身体功能，和社会心理因素的管理。采用二元logistic回归分析估计独立和组合奇数比（ORs）。诸如相互作用导致的相对超额风险(RERI)等衡量标准，由于相互作用而产生的风险的可归属比例，并使用协同指数评估CF与合并症之间的相互作用。
结果：与没有CF的参与者（10.3％）相比，有CF的参与者（24.1％）更有可能报告残疾。CF和骨关节炎（OA）之间观察到影响残疾的协同作用（OR：6.675，95％CI：1.057-42.158；RERI：1.501，95％CI：1.400-1.570），CF和心脏病（HD）（OR：3.480，95％CI：1.378-8.786；RERI：0.875，95％CI：0.831-0.919），CF和抑郁症状（OR：3.443，95％CI：1.065-11.126；RERI：0.806，95％CI：0.753-0.859），在CF和糖尿病（DM）之间（OR：2.904，95％置信区间（CI）：1.487-5.671；RERI：0.607，95％CI：0.577-0.637）。
结论：这些发现突出了CF与合并症共存之间的协同作用，包括OA,HD,DM,和抑郁症状,关于老年人的残疾。筛选,评估,管理合并症，尤其是OA,HD,DM和抑郁症状，管理患有CF的老年人对于降低残疾风险或预防残疾发展至关重要.
方法：在马来西亚迈向有用衰老（TUA）研究的1318名参与者中，5年随访分析中仅纳入400例.一份全面的基于访谈的问卷，涵盖社会人口统计信息，健康状况,生化指标,认知和身体功能，和社会心理因素的管理。采用二元logistic回归分析估计独立和组合奇数比（ORs）。诸如相互作用导致的相对超额风险(RERI)等衡量标准，由于相互作用而产生的风险的可归属比例，并使用协同指数评估CF与合并症之间的相互作用。
结果：与没有CF的参与者（10.3％）相比，有CF的参与者（24.1％）更有可能报告残疾。CF和骨关节炎（OA）之间观察到影响残疾的协同作用（OR：6.675，95％CI：1.057-42.158；RERI：1.501，95％CI：1.400-1.570），CF和心脏病（HD）（OR：3.480，95％CI：1.378-8.786；RERI：0.875，95％CI：0.831-0.919），CF和抑郁症状（OR：3.443，95％CI：1.065-11.126；RERI：0.806，95％CI：0.753-0.859），在CF和糖尿病（DM）之间（OR：2.904，95％置信区间（CI）：1.487-5.671；RERI：0.607，95％CI：0.577-0.637）。
结论：这些发现突出了CF与合并症共存之间的协同作用，包括OA,HD,DM,和抑郁症状,关于老年人的残疾。筛选,评估,管理合并症，尤其是OA,HD,DM和抑郁症状，管理患有CF的老年人对于降低残疾风险或预防残疾发展至关重要.
