Cognitive Frailty and Its Relationship with Adverse Health Outcomes among Community Dwelling Older Adults

Project: National Science and Technology CouncilNational Science and Technology Council Academic Grants

Project Details


Background: In 2013, the concept and operational definition of “cognitive frailty”, the simultaneous presence of physical frailty and cognitive impairment but without dementia was proposed by the International Academy on Nutrition and Aging and the International Association of Gerontology and Geriatrics (IANA-IAGG). However, in Taiwan, to date the cognitive frailty profile and associated factors among community-dwelling older adults have not yet been well characterized. Objective: The objectives of this study are shown as followed. To investigate the prevalence of cognitive frailty among older adults in Taiwan, we also aimed to explore the association between health and socioeconomic factors and cognitive frailty in older adults. To examine whether cognitive frailty was associated with increased risk of incidence of dementia. We also aimed to explore the impact of dementia on health care service utilization among older adults in Taiwan. To examine whether cognitive frailty was associated with increased risk of emergency department use, repeated hospitalizations, and mortality. We also aimed to explore the impact of cognitive frailty on health care service utilization among older adults in Taiwan. Method: The study population included participants in the National Health Interview Survey (NHIS) in Taiwan in 2013. Those individuals aged 65 and above will be included in this study. Of the potential participants, those who provided consent for data linkage to claims data from the National Health Insurance (2014-2018) could be obtained, will be eligible for analysis to explore the association between cognitive frailty and dementia, emergency department use, and repeated hospitalizations in the present study. Deaths will be verified by indexing to the 2014-2018 National Register of Deaths with a personal identification number. The Mini-Mental State Examination was used to assess cognitive function. The presence of frailty was determined based on FRAIL scale proposed by the International Association of Nutrition and Aging. We assess factors considered to be associated with cognitive frailty in older adults including the age, gender, education levels, marriage status, income, health-related behaviors, comorbidities, depressive symptoms, social engagement, and the limitations of activities of daily living. The area under the receiver operating characteristic (ROC) curve (AUC) will be used to measure the concordance of predictive values with outcomes. Logistic regression analysis will be performed to assess the association between cognitive frailty and its associated factors. Negative binomial regression will be used to estimate the parameters specified in the health care utilization model. Multivariate Cox’s proportional hazards models will be used to examine the association dementia and cognitive frailty and mortality. We will use the SAS (SAS Institute, Cary, NC) for all analyses.

Project IDs

Project ID:PF10901-2184
External Project ID:MOST108-2410-H182-010-MY3
Effective start/end date01/08/2031/07/21


  • Pediatric Cancer
  • Truth-telling
  • Communication Skill Training
  • Triangulation
  • Truth-telling Ability


Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint.