Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery
Background Older adults undergoing surgery frequently have multiple comorbidities and reduced physical and cognitive reserves. This study aims to assess the effect of physical and cognitive frailty on long-term mortality in older patients undergoing elective non-cardiac surgery in a tertiary center....
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korea Geriatrics Society
2025-03-01
|
| Series: | Annals of Geriatric Medicine and Research |
| Subjects: | |
| Online Access: | http://www.e-agmr.org/upload/pdf/agmr-24-0163.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849766657193410560 |
|---|---|
| author | Min-Jie Low Zhen Yi Liau Jun Leong Cheong Pui San Loh Ina Ismiarti Shariffuddin Hui Min Khor |
| author_facet | Min-Jie Low Zhen Yi Liau Jun Leong Cheong Pui San Loh Ina Ismiarti Shariffuddin Hui Min Khor |
| author_sort | Min-Jie Low |
| collection | DOAJ |
| description | Background Older adults undergoing surgery frequently have multiple comorbidities and reduced physical and cognitive reserves. This study aims to assess the effect of physical and cognitive frailty on long-term mortality in older patients undergoing elective non-cardiac surgery in a tertiary center. Methods Patients aged ≥65 years old admitted to surgical wards at the University of Malaya Medical Centre were recruited. Physical frailty and cognitive status were assessed using the Fried Frailty Index (FFI) and the Montreal Cognitive Assessment, respectively. Patients were stratified into six groups based on their frailty and cognitive status: Group 1, normal cognition and non-frail (reference group); Group 2, normal cognition and frail; Group 3, mild cognitive impairment (MCI) and non-frail; Group 4, MCI and frail; Group 5, dementia and non-frail; and Group 6, dementia and frail. Results A total of 406 patients with a mean FFI score of 1.1±1.2 were recruited. Predictors of mortality include male sex (hazard ratio [HR]=1.96; 95% confidence interval [CI], 1.14–3.37; p=0.015), presence of active malignancy (HR=3.86; 95% CI, 2.14–6.95; p<0.001), and high FFI scores (1.8±1.2 vs. 1.0±1.1; p=0.013). Compared to Group 1, long-term mortality risk was significantly increased in Group 4 (HR=3.17; 95% CI, 1.36–7.38) and Group 6 (HR=3.91; 95% CI, 1.62–9.43) patients. Conclusion The combination of physical frailty and cognitive impairment was associated with long-term mortality risk among older patients who underwent elective non-cardiac surgery. This highlights the importance of assessing physical frailty and cognitive function of all older surgical patients to guide targeted intervention, especially for those with impairments which may be potentially reversible. |
| format | Article |
| id | doaj-art-4255b172497a449b8eb34cd71eef65f4 |
| institution | DOAJ |
| issn | 2508-4798 2508-4909 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Korea Geriatrics Society |
| record_format | Article |
| series | Annals of Geriatric Medicine and Research |
| spelling | doaj-art-4255b172497a449b8eb34cd71eef65f42025-08-20T03:04:30ZengKorea Geriatrics SocietyAnnals of Geriatric Medicine and Research2508-47982508-49092025-03-0129111111810.4235/agmr.24.01631178Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac SurgeryMin-Jie Low0Zhen Yi Liau1Jun Leong Cheong2Pui San Loh3Ina Ismiarti Shariffuddin4Hui Min Khor5 Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia Department of Anaesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia Department of Anaesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia Department of Anaesthesiology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, MalaysiaBackground Older adults undergoing surgery frequently have multiple comorbidities and reduced physical and cognitive reserves. This study aims to assess the effect of physical and cognitive frailty on long-term mortality in older patients undergoing elective non-cardiac surgery in a tertiary center. Methods Patients aged ≥65 years old admitted to surgical wards at the University of Malaya Medical Centre were recruited. Physical frailty and cognitive status were assessed using the Fried Frailty Index (FFI) and the Montreal Cognitive Assessment, respectively. Patients were stratified into six groups based on their frailty and cognitive status: Group 1, normal cognition and non-frail (reference group); Group 2, normal cognition and frail; Group 3, mild cognitive impairment (MCI) and non-frail; Group 4, MCI and frail; Group 5, dementia and non-frail; and Group 6, dementia and frail. Results A total of 406 patients with a mean FFI score of 1.1±1.2 were recruited. Predictors of mortality include male sex (hazard ratio [HR]=1.96; 95% confidence interval [CI], 1.14–3.37; p=0.015), presence of active malignancy (HR=3.86; 95% CI, 2.14–6.95; p<0.001), and high FFI scores (1.8±1.2 vs. 1.0±1.1; p=0.013). Compared to Group 1, long-term mortality risk was significantly increased in Group 4 (HR=3.17; 95% CI, 1.36–7.38) and Group 6 (HR=3.91; 95% CI, 1.62–9.43) patients. Conclusion The combination of physical frailty and cognitive impairment was associated with long-term mortality risk among older patients who underwent elective non-cardiac surgery. This highlights the importance of assessing physical frailty and cognitive function of all older surgical patients to guide targeted intervention, especially for those with impairments which may be potentially reversible.http://www.e-agmr.org/upload/pdf/agmr-24-0163.pdffrailtycognitionsurgeryagedmortality |
| spellingShingle | Min-Jie Low Zhen Yi Liau Jun Leong Cheong Pui San Loh Ina Ismiarti Shariffuddin Hui Min Khor Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery Annals of Geriatric Medicine and Research frailty cognition surgery aged mortality |
| title | Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery |
| title_full | Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery |
| title_fullStr | Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery |
| title_full_unstemmed | Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery |
| title_short | Impact of Physical and Cognitive Frailty on Long-Term Mortality in Older Patients undergoing Elective Non-cardiac Surgery |
| title_sort | impact of physical and cognitive frailty on long term mortality in older patients undergoing elective non cardiac surgery |
| topic | frailty cognition surgery aged mortality |
| url | http://www.e-agmr.org/upload/pdf/agmr-24-0163.pdf |
| work_keys_str_mv | AT minjielow impactofphysicalandcognitivefrailtyonlongtermmortalityinolderpatientsundergoingelectivenoncardiacsurgery AT zhenyiliau impactofphysicalandcognitivefrailtyonlongtermmortalityinolderpatientsundergoingelectivenoncardiacsurgery AT junleongcheong impactofphysicalandcognitivefrailtyonlongtermmortalityinolderpatientsundergoingelectivenoncardiacsurgery AT puisanloh impactofphysicalandcognitivefrailtyonlongtermmortalityinolderpatientsundergoingelectivenoncardiacsurgery AT inaismiartishariffuddin impactofphysicalandcognitivefrailtyonlongtermmortalityinolderpatientsundergoingelectivenoncardiacsurgery AT huiminkhor impactofphysicalandcognitivefrailtyonlongtermmortalityinolderpatientsundergoingelectivenoncardiacsurgery |