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Evaluating the association of physical frailty with cognitive impairment: a clinical perspective in older adults of Bangladesh

BMC Geriatr. 2026 Jan 8. doi: 10.1186/s12877-026-06971-4. Online ahead of print.

ABSTRACT

BACKGROUND: Although physical frailty has long been recognized as a clinical condition, it has only recently gained attention in Bangladesh. This growing interest reflects the country’s increasing focus on the health challenges faced by its aging population. This study examined the prevalence of physical frailty and its association with cognitive impairment among older adults.

METHODS: The study used a cross-sectional design conducted among 540 older adults aged 65 and above using a multistage sampling technique. Physical frailty status was assessed using the Fried frailty phenotype, and cognitive function was measured with the 30-item Mini-Mental State Examination.

RESULTS: Across two districts, 60% of participants were classified as frail, and 33% were classified as pre-frail. Significant demographic differences were observed across frailty categories, including age, gender, marital status, net monthly income level, and smoking history (p < 0.001). Multinomial logistic regression analyses indicated that several demographic and clinical factors were associated with cognitive impairment, including gender, education, household income, and multimorbidity. Higher household income (> 60,000 Bangladeshi Taka [BDT] per month) was associated with lower odds of severe cognitive impairment (OR = 0.14, 95% CI = 0.04, 0.45). Regular visits from family or friends showed a suggestive association with lower odds of cognitive impairment (OR = 0.59, 95% CI = 0.03, 1.54), although this association did not reach statistical significance at the 0.05 level. Cognitive function tended to be lower among frail participants aged 81 and above, with the lowest observed scores.

CONCLUSION: The findings demonstrate a significant association between physical frailty and cognitive impairment among older adults in Bangladesh, emphasizing the role of social determinants in shaping these outcomes. The results highlight the need for targeted interventions and policy strategies addressing these determinants to promote healthy aging and mitigate cognitive decline in this population.

PMID:41501676 | DOI:10.1186/s12877-026-06971-4

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