Frailty and Cognitive Decline in Hospitalized Elderly Patients: Associations with Clinical and Laboratory Parameters

BACKGROUND Frailty syndrome (FS) and cognitive impairment are major geriatric concerns, particularly prevalent among hospitalized older adults. The primary objective of this study was to assess the co-occurrence of FS and cognitive impairment in hospitalized geriatric patients. Additionally, the study analyzed the relationship of these conditions with functional status, fall risk, sensory deficits, depressive symptoms, and selected prognostic laboratory parameters. The research hypothesis was that the severity of frailty is correlated with worse cognitive impairment. MATERIAL AND METHODS This retrospective study analyzed the medical records of 265 patients consecutively admitted to the Internal Medicine and Geriatrics Ward of the Clinic of Internal Medicine and Cardiology at the University Clinical Centre of the Medical University of Warsaw (UCK WUM) between January 1 and December 31, 2022. During hospitalization, all patients underwent a comprehensive geriatric assessment (CGA), which included the following tools: the Katz Index of Independence in Activities of Daily Living (ADL), the Lawton Instrumental Activities of Daily Living Scale (IADL), the Barthel Index, the Short Tinetti Test, the Norton Scale, the Mini-Mental State Examination (MMSE), and the 15-item Geriatric Depression Scale (GDS-15). Frailty was assessed using the Clinical Frailty Scale (CFS). Laboratory analysis included serum levels of albumin, hemoglobin, lymphocytes, sodium, and thyroid-stimulating hormone (TSH). RESULTS Most patients (64.77%) exhibited signs of frailty - 21.59% were classified as pre-frail and 13.63% were non-frail. Frailty severity was correlated with worsening cognitive impairment. Statistically significant associations were observed between CFS scores and clinical parameters such as age (P<0.001), albumin level (P<0.001), hemoglobin level (P=0.002), lymphocyte count (P=0.292), and MMSE score (P<0.001). Scores of functional assessment tools - ADL, IADL, the Norton Scale, the Barthel Index, and the Tinetti Test - were significantly correlated (P<0.05) with both CFS and MMSE outcomes. CONCLUSIONS In hospitalized geriatric patients, frailty severity is associated with cognitive decline and decreased functional performance. Lower levels of albumin and lymphocytes were associated with more advanced frailty and worse cognitive dysfunction.