The journal of nutrition, health & aging

, Volume 23, Issue 10, pp 943–948 | Cite as

Cognitive Frailty and Its Association with Nutrition and Depression in Community-Dwelling Older People

  • R. Y. C. Kwan
  • A. Y. M. Leung
  • A. Yee
  • L. T. Lau
  • X. Y. Xu
  • David L. K. DaiEmail author



Cognitive frailty is a condition where physical frailty and mild cognitive impairment (MCI) co-exist. It is associated with increased risk of dementia and dependency. Previous studies reported that malnutrition and depression are associated with physical frailty and MCI; however, their relationships with cognitive frailty remained to be explored. The aims of this study were to examine the association of nutrition and depression with cognitive frailty, in comparison to having physical frailty or MCI alone.


This study employed a cross-sectional design. Data collection was conducted in the community settings on the older people without dementia. Dependent variables were cognitive frailty, physical frailty, and MCI. The independent variables were depression and nutrition. Multi-nominal regression was employed to examine the relationships between the dependent and independent variables. The associations were adjusted by four known co-variates, including age, gender, education and APOE ε4 carrier status.


A total of 185 participants were recruited from four community centres and one elderly hostel and completed the data collection. Approximately 44.9% of the older people with physical frailty and 82.5% of elderly with MCI belonged to cognitive frailty. Multi-nominal regression models showed that depression is positively associated with cognitive frailty and with physical frailty, but not associated with solely MCI. Nutrition is negatively associated with cognitive frailty, but not associated with physical frailty or MCI alone.


Cognitive frailty is associated with malnutrition and depression. Therapeutic interventions managing depression and malnutrition may focus the older people with cognitive frailty to improve efficacy and cost-effectiveness.

Key words

Cognitive frailty nutrition depression APOE gene 


Conflict of interest: Moonchu Foundation funded the project; none of the authors have any conflict of interest to declare

Ethical standards: This article complies with the law. The study received an ethical approval from the institutional review board at The Hong Kong Polytechnic University with the reference number of HSEARS20161101002.


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Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • R. Y. C. Kwan
    • 1
  • A. Y. M. Leung
    • 1
  • A. Yee
    • 2
  • L. T. Lau
    • 3
  • X. Y. Xu
    • 1
  • David L. K. Dai
    • 4
    Email author
  1. 1.Centre for Gerontological Nursing, School of NursingThe Hong Kong Polytechnic UniversityHong KongChina
  2. 2.Avalon Genomics (Hong Kong) LimitedHong KongChina
  3. 3.Department of Applied Biology and Chemical TechnologyThe Hong Kong Polytechnic UniversityHong KongChina
  4. 4.Hong Kong Alzheimer’s Disease AssociationHong KongChina

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