1
|
Ghanbarnia MJ, Hosseini SR, Ahangar AA, Ghadimi R, Bijani A. Prevalence of cognitive frailty and its associated factors in a population of Iranian older adults. Aging Clin Exp Res 2024; 36:134. [PMID: 38902508 PMCID: PMC11189957 DOI: 10.1007/s40520-024-02790-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/09/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND In recent years cognitive frailty has emerged as an important predictor of adverse health outcomes in older adults. Herein, we aimed to investigate the prevalence and associated factors of cognitive frailty in a population of community-dwelling older adults in Iran. METHOD This cross-sectional study was conducted as part of the second cycle of the Amirkola Health and Aging Project (AHAP). Physical frailty and cognitive impairment were evaluated using the FRAIL questionnaire and the mini-mental state examination (MMSE) respectively. Cognitive frailty was defined as co-existence of frailty and cognitive impairment without presence of dementia. Depression and disability were assessed using the Persian version of geriatric depression scale (GDS) and instrumental activities of daily living (IADL) questionnaire. RESULTS Overall 1775 individuals (47.1% female) with mean age of 69.7 ± 7.3 years were included in the final analysis. The prevalence of cognitive frailty was 12.0%. The prevalence of cognitive frailty among males and females was 4.3% and 20.7%, respectively. After adjusting for all possible confounders through binary logistic regression analysis, factors such as older age (OR 1.06, CI 1.03-1.09), female gender (OR 2.25, CI 1.42-3.57), illiteracy (OR 3.84, CI 2.03-8.29), more comorbidities (OR 1.21, CI 1.12-1.31), depression (OR 2.01, CI 1.40-2.86), and greater IADL disability (OR 1.68, CI 1.44-3.96), were independently and significantly associated with cognitive frailty. CONCLUSION In this population of Iranian older adults, prevalence of cognitive frailty was consistent with its estimated mean global prevalence. Age, gender, illiteracy, comorbidities, depression and IADL disability were associated with cognitive frailty. Further research is required to develop screening tools and prevention strategies.
Collapse
Affiliation(s)
- Mohammad Javad Ghanbarnia
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Ophthalmology, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Alijan Ahmadi Ahangar
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
2
|
de Santana BRF, Borim FSA, de Assumpção D, Neri AL, Yassuda MS. Frailty and functional status among older adults with cognitive impairment: data from the second wave of the FIBRA study. Dement Neuropsychol 2024; 18:e20230051. [PMID: 38425699 PMCID: PMC10901559 DOI: 10.1590/1980-5764-dn-2023-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 03/02/2024] Open
Abstract
Frailty is defined as a recognizable state of increased vulnerability resulting from age-associated decline of function in various physiological systems, such that the ability to deal with acute or everyday stressors is compromised. Objective The aim of the study was to characterize the sample of older adults with cognitive impairment, according to the frailty status indirectly assessed by family members, other clinical and sociodemographic variables; and to assess the overlap of clinical conditions evaluated in this sample with cognitive impairment. Methods Data were extracted from the follow-up database of the Frailty in Brazilian Older Adults (FIBRA) study (2016-2017). The sample consisted of 130 elderly people with cognitive impairment assessed by the Mini Mental State Examination (MMSE). The scores for the Clinical Dementia Scale (CDR), Cornell Scale for Depression in Dementia and Functional Activities Questionnaire were described. Frailty was indirectly measured through questions answered by family members about the five criteria that compose the frailty phenotype. Results The sample consisted mostly of older women (n=91) with a mean age of 82.4 (SD=5.3) years, mean schooling of 3.3 years (SD=3.07), widowed (47.7%) and who lived with children and/or grandchildren (68%). More than half had multimorbidity (74.90%), 39.5% had depression symptoms suggestive of major depression, 57% had impaired functionality, 49.3% were frail, 37.6% pre-frail, and 13.10% robust. Conclusion Among older adults with cognitive impairment, frailty and functional limitations are common.
Collapse
Affiliation(s)
- Beatriz Raz Franco de Santana
- Postgraduate Program in Gerontology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas SP, Brazil
| | - Flávia Silva Arbex Borim
- Postgraduate Program in Gerontology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas SP, Brazil
| | - Daniela de Assumpção
- Postgraduate Program in Gerontology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas SP, Brazil
| | - Anita Liberalesso Neri
- Postgraduate Program in Gerontology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas SP, Brazil
| | - Mônica Sanches Yassuda
- Postgraduate Program in Gerontology, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas SP, Brazil
- Gerontolgy, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo SP, Brazil
| |
Collapse
|
3
|
Nader MM, Cosarderelioglu C, Miao E, Whitson H, Xue QL, Grodstein F, Oh E, Ferrucci L, Bennett DA, Walston JD, George C, Abadir PM. Navigating and diagnosing cognitive frailty in research and clinical domains. NATURE AGING 2023; 3:1325-1333. [PMID: 37845509 DOI: 10.1038/s43587-023-00504-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
While physical frailty has been recognized as a clinical entity for some time, the concept of cognitive frailty (CF) is now gaining increasing attention in the geriatrics research community. CF refers to the co-occurrence of physical frailty and cognitive impairment in older adults, which has been suggested as a potential precursor to both dementia and adverse physical outcomes. However, this condition represents a challenge for researchers and clinicians, as there remains a lack of consensus regarding the definition and diagnostic criteria for CF, which has limited its utility. Here, using insights from both the physical frailty literature and cognitive science research, we describe emerging research on CF. We highlight areas of agreement as well as areas of confusion and remaining knowledge gaps, and provide our perspective on fine-tuning the current construct, aiming to stimulate further discussion in this developing field.
Collapse
Affiliation(s)
- Monica M Nader
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Caglar Cosarderelioglu
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Ankara University School of Medicine, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
| | - Emily Miao
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Heather Whitson
- Duke University School of Medicine, Center for the Study of Aging, Durham, NC, USA
| | - Qian-Li Xue
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Esther Oh
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | | | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Jeremy D Walston
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Claudene George
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Peter M Abadir
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA.
| |
Collapse
|
4
|
O'Connor D, Molloy AM, Laird E, Kenny RA, O'Halloran AM. Sustaining an ageing population: the role of micronutrients in frailty and cognitive impairment. Proc Nutr Soc 2023; 82:315-328. [PMID: 36938798 DOI: 10.1017/s0029665123002707] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Age-related frailty and cognitive decline are complex multidimensional conditions that significantly impact the ability of older adults to sustain functional capacity and independence. While underlying causes remain poorly understood, nutrition continually emerges as one associated risk element. Many studies have addressed the importance of adequate nutrition in delaying the onset of these conditions, but the specific role of micronutrients is not well established. The consideration of pre-frailty as an outcome variable is also limited in the current literature. In this review, we focus on the potential value of maintaining micronutrient sufficiency to sustaining the health of the ageing population. Using data from the Irish longitudinal study on ageing, we consider several vitamins known to have a high prevalence of low status in older adults and their impact on pre-frailty, frailty and cognitive impairment. They include vitamin B12 and folate, both of which are associated with multiple biological mechanisms involved in long-term health, in particular in cognitive function; vitamin D, which has been associated with increased risk of musculoskeletal disorders, depression and other chronic diseases; and the carotenoids, lutein and zeaxanthin, that may help mitigate the risk of frailty and cognitive decline via their antioxidant and anti-inflammatory properties. We show that low concentrations of folate and carotenoids are implicated in poorer cognitive health and that the co-occurrence of multiple nutrient deficiencies confers greatest risk for frailty and pre-frailty in the Irish longitudinal study on ageing cohort. These health associations contribute to evidence needed to optimise micronutrient status for health in the older adult population.
Collapse
Affiliation(s)
- Deirdre O'Connor
- TILDA, Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Anne M Molloy
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| | - Eamon Laird
- TILDA, Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- Department of Physical Education and Sport, University of Limerick, Limerick, Ireland
| | - Rose Anne Kenny
- TILDA, Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- Mercer's Institute for Successful Ageing, St James's Hospital, Dublin, Ireland
| | - Aisling M O'Halloran
- TILDA, Medical Gerontology, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
| |
Collapse
|
5
|
Garcia TFM, Vallero CNDA, Assumpção DD, Aprahamian I, Mônica Sanches Y, Borim FSA, Neri AL. Number of ideas in spontaneous speech predicts cognitive impairment and frailty in community-dwelling older adults nine years later. Aging Ment Health 2022; 26:2022-2030. [PMID: 34806510 DOI: 10.1080/13607863.2021.1998347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the associations between linguistic parameters in spontaneous speech at baseline and cognitive impairment and frailty nine years later. METHODS A prospective analysis was carried out on data of the Frailty in Brazilian Older People Study (FIBRA) Study, a population-based study on frailty. From a probabilistic sample of 384 individuals aged 65 and older at baseline (2008-2009), 124 aged 73 years and older at follow-up were selected, as they had scored above the cutoff values of cognitive screening for dementia adjusted by years of schooling at baseline and had answered to the question What is healthy aging and had no frailty at baseline. Verbal responses were submitted to content analysis and had its ideas and words counted. Number of ideas corresponded to the frequency of meaning categories and number of words to all identified significant textual elements in the text constituted by the sample answers to that question. RESULTS Multivariate logistic regression analyses, controlling for the effects of age, sex, and education, showed that individuals with a high number of ideas at baseline had lower chance of having cognitive impairment (OR = 0.39; 95% CI 0.22 - 0.69) and frailty (OR 0.66; 95% CI 0.44 - 0.99) nine years later than those with low number of ideas. CONCLUSIONS Higher number of ideas, but not number of words, in spontaneous speech seems to be associated to a more positive prognosis in mental and physical health nine years later. Linguistic markers may be used to predict cognitive impairment and frailty in older individuals.
Collapse
Affiliation(s)
| | | | | | - Ivan Aprahamian
- Group of Investigation on Multimorbidity and Mental Health in Aging (GIMMA), Geriatrics Division, Internal Medicine Department, Faculty of Medicine of Jundiaí, Jundiaí, Brazil.,Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yassuda Mônica Sanches
- School of Medical Sciences, State University of Campinas, Campinas, Brazil.,School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | | | | |
Collapse
|
6
|
García-Sánchez J, Mafla-España MA, Tejedor-Cabrera C, Avellán-Castillo O, Torregrosa MD, Cauli O. Plasma Aromatase Activity Index, Gonadotropins and Estrone Are Associated with Frailty Syndrome in Post-Menopausal Women with Breast Cancer. Curr Oncol 2022; 29:1744-1760. [PMID: 35323344 PMCID: PMC8947022 DOI: 10.3390/curroncol29030144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/01/2022] [Accepted: 03/04/2022] [Indexed: 01/04/2023] Open
Abstract
Frailty syndrome is associated with poor outcomes, morbidity and premature mortality. We performed a cross-sectional study to evaluate the presence of frailty syndrome based on Fried’s frailty phenotype in post-menopausal women with breast cancer. We further analyzed the association between frailty syndrome with geriatric assessments and the association with the concentration of gonadotropins LH and FSH, estrogens, androgens and the aromatase activity index in the blood. We enrolled 47 post-menopausal women with localized breast cancer (mean age 66.8 ± 1.3 years (range 52−83)) prior to the starting of adjuvant endocrine therapy. Patients were identified as “non-frail” (robust) or “prefrail/frail” if they fulfilled at least one frailty criteria. In order to determine associations among variables and to control for other variables potentially affecting frailty syndrome (age, comorbidity index and previous chemotherapy treatment), we performed a logistic regression analysis. The receiver operating characteristic curve was performed to assess the sensitivity and specificity of the hormonal concentration to discriminate prefrail/frail versus non-frail individuals. Significant positive associations were observed between the severity of frailty syndrome and estrone, FSH and LH concentrations and the aromatase activity index in the blood (p < 0.05). Further research into the role of hormonal biomarkers should be evaluated in follow-up studies in order to recommend their use as suitable biomarkers of frailty syndrome in breast cancer patients.
Collapse
Affiliation(s)
- Javier García-Sánchez
- Medical Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain; (J.G.-S.); (M.D.T.)
- Medical Oncology Department, Hospital Center of Wallonie Picardy, 7500 Tournai, Belgium
| | - Mayra Alejandra Mafla-España
- Frailty Research Organized Group, University of Valencia, 46010 Valencia, Spain;
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
| | - Carlos Tejedor-Cabrera
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
| | - Olga Avellán-Castillo
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
| | - María Dolores Torregrosa
- Medical Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain; (J.G.-S.); (M.D.T.)
| | - Omar Cauli
- Frailty Research Organized Group, University of Valencia, 46010 Valencia, Spain;
- Department of Nursing, University of Valencia, 46010 Valencia, Spain; (C.T.-C.); (O.A.-C.)
- Correspondence:
| |
Collapse
|
7
|
Tapper EB, Kenney B, Nikirk S, Levine DA, Waljee AK. Animal Naming Test Is Associated With Poor Patient-Reported Outcomes and Frailty in People With and Without Cirrhosis: A Prospective Cohort Study. Clin Transl Gastroenterol 2022; 13:e00447. [PMID: 35080516 PMCID: PMC8806368 DOI: 10.14309/ctg.0000000000000447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 12/06/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Cognitive dysfunction is a major driver of care complexity, poor patient-reported outcomes, and frailty for people with cirrhosis. The performance and clinical associations of the animal naming test (ANT) in the general population are unknown. We evaluated ANT performance in a representative sample of older Americans with and without chronic liver disease (CLD). METHODS We analyzed 6,661 subjects enrolled in the 2010-2016 Health and Retirement Survey, a representative cohort of >30,000 US adults. Average age of participants was 75 years. We evaluated 3 subject subgroups: (i) without CLD, (ii) noncirrhosis CLD, and (iii) cirrhosis. We determined the association between the ANT (overall) and S-ANT1 <10 (adjusted for age and education) and health status, basic and instrumental activities of daily living, healthcare utilization (care hours received and hospitalizations), and frailty measures (hand grip and walk speed). RESULTS Overall, 8.2% of the sample had noncirrhotic CLD and 1.3% had cirrhosis. CLD or cirrhosis was not independently associated with ANT. Poor ANT performance was associated with poor health status and frailty overall. An S-ANT <10 was associated with fair-poor self-reported health (odds ratio [OR] 1.37; 95% confidence interval [CI]: 1.20-1.56), care hours received (incidence rate ratio [IRR] 2.39; 95% CI: 1.79-3.19), and hospitalizations (IRR 1.14; 95% CI: 1.03-1.26). S-ANT <10 was also associated with activities of daily living disability (OR 1.31; 95% CI: 1.13-1.51), instrumental activities of daily living disability (OR 1.85; 95% CI: 1.59-2.14), weaker hand grip (IRR 0.94; 95% CI: 0.92-0.96), and time to walk 2.5 m (IRR 1.23; 95% CI: 1.17-1.29). DISCUSSION ANT performance is not specific to CLD/cirrhosis but is associated with patient-reported outcomes and frailty in a nationally representative sample of elderly subjects with and without CLD.
Collapse
Affiliation(s)
- Elliot B. Tapper
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Brooke Kenney
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan, USA
| | - Samantha Nikirk
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Deborah A. Levine
- Division of General Medicine, Department of Internal Medicine and Cognitive Health Services Research Program, University of Michigan (U-M), Ann Arbor, Michigan, USA
| | - Akbar K. Waljee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Center for Clinical Management Research, Veterans Affairs Ann Arbor Health System, Ann Arbor, Michigan, USA
| |
Collapse
|
8
|
Sharifi F, Khoiee MA, Aminroaya R, Ebrahimpur M, Shafiee G, Heshmat R, Payab M, Shadman Z, Fakhrzadeh H, Arzaghi SM, Mehrdad N, Ostovar A, Sheidaei A, Fahimfar N, Nabipour I, Larijani B. Studying the relationship between cognitive impairment and frailty phenotype: a cross-sectional analysis of the Bushehr Elderly Health (BEH) program. J Diabetes Metab Disord 2021; 20:1229-1237. [PMID: 34900774 PMCID: PMC8630203 DOI: 10.1007/s40200-021-00847-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/23/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Some pathophysiological effects of physical frailty and cognitive impairment might be similar; therefore, finding the associations in epidemiologic studies could guide clinicians and researchers to recognize effective strategies for each type of frailty such as frailty phenotype and frailty index, which in turn will result in a preventive approach. The study aimed to reveal which components of frailty phenotype are more associated with cognitive impairment. The findings of this study may help other researchers clarify the related pathways. METHODS This is a cross-sectional analysis of the results of the second phase of Bushehr Elderly Health Program; a community-based elderly prospective cohort study conducted in 2015-2016. The participants were selected through a multistage stratified cluster random sampling method. Frailty was assessed based on the Fried frailty phenotype criteria. Cognitive impairment was assessed by the Mini-Mental State Examination (MMSE), the Mini-Cog, and the Category Fluency Test (CFT). Multiple logistic regression models were applied to determine the association between frailty and cognitive impairment. Depression trait was assessed using the Patient Health Questionnaire-9 (PHQ-9). Activities of daily living were assessed using the Barthel Index and Instrumental Activities of Daily Living (IADLs) using Lawton's IADL. RESULTS The studyp conducted among people ≥ 60 years old (N = 2336) with women consisting 51.44% of the sample group. The mean age of the participants was 69.26 years old. The prevalence of pre-frailty and frailty were 42.59% and 7.66%, respectively. In the fully adjusted model, the odds ratio of the association between pre-frailty and frailty with cognitive impairment was 1.239, 95% CI: 1.011 - 1.519 and 1.765, 95% CI: 1.071 - 2.908, respectively (adjusted for age, sex, education, body mass index, smoking, diabetes mellitus, PHQ- 9, Barthel Index, and IADLs). In the fully adjusted multiple logistic regression models, all of the components of Fried frailty phenotype were significantly related to cognitive impairment except weight loss. CONCLUSION Cognitive impairment may be associated with frailty phenotype. Moreover, low strength and function of muscles had a stronger association with cognitive impairment. It seems that a consideration of cognitive impairment assessment in older people along with frailty and vice versa in clinical settings is reasonable.
Collapse
Affiliation(s)
- Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Alizadeh Khoiee
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Reihane Aminroaya
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moloud Payab
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhaleh Shadman
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sheidaei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, NO. 10, Jalale-Al- Ahmad Ave, Chamran Highway, Tehran, Iran
| |
Collapse
|
9
|
Williams AM, Krull KR, Howell CR, Banerjee P, Brinkman TM, Kaste SC, Partin RE, Srivastava D, Yasui Y, Armstrong GT, Robison LL, Hudson MM, Ness KK. Physiologic Frailty and Neurocognitive Decline Among Young-Adult Childhood Cancer Survivors: A Prospective Study From the St Jude Lifetime Cohort. J Clin Oncol 2021; 39:3485-3495. [PMID: 34283634 DOI: 10.1200/jco.21.00194] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Eight percent of young-adult childhood cancer survivors meet criteria for frailty, an aging phenotype associated with poor health. In the elderly general population, frailty is associated with neurocognitive decline; this association has not been examined in adult survivors of childhood cancer. METHODS Childhood cancer survivors 18-45 years old (≥ 10 years from diagnosis) were clinically evaluated for prefrailty or frailty (respectively defined as ≥ 2 or ≥ 3 of: muscle wasting, muscle weakness, low energy expenditure, slow walking speed, and exhaustion [Fried criteria]) and completed neuropsychologic assessments at enrollment (January 2008-June 2013) and 5 years later. Weighted linear regression using inverse of sampling probability estimates as weights compared differences in neurocognitive decline in prefrail and frail survivors versus nonfrail survivors, adjusting for diagnosis age, sex, race, CNS-directed therapy (cranial radiation, intrathecal chemotherapy, and neurosurgery), and baseline neurocognitive performance. RESULTS Survivors were on average 30 years old and 22 years from diagnosis; 18% were prefrail and 6% frail at enrollment. Frail survivors declined an average of 0.54 standard deviation (95% CI, -0.93 to -0.15) in short-term verbal recall, whereas nonfrail survivors did not decline (β = .22; difference of βs = -.76; 95% CI, -1.19 to -0.33). Frail survivors declined more than nonfrail survivors on visual-motor processing speed (β = -.40; 95% CI, -0.67 to -0.12), cognitive flexibility (β = -.62; 95% CI, -1.02 to -0.22), and verbal fluency (β = -.23; 95% CI, -0.41 to -0.05). Prefrail and frail survivors experienced greater declines in focused attention (prefrail β = -.35; 95% CI, -0.53 to -0.17; frail β = -.48; 95% CI, -0.83 to -0.12) compared with nonfrail survivors. CONCLUSION Over approximately 5 years, prefrail and frail young-adult survivors had greater declines in cognitive domains associated with aging and dementia compared with nonfrail survivors. Interventions that have global impact, designed to target the mechanistic underpinnings of frailty, may also mitigate or prevent neurocognitive decline.
Collapse
Affiliation(s)
- AnnaLynn M Williams
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN.,Department of Psychology, St Jude Children's Research Hospital, Memphis, TN
| | - Carrie R Howell
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Pia Banerjee
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN.,Department of Psychology, St Jude Children's Research Hospital, Memphis, TN
| | - Sue C Kaste
- Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN
| | - Robyn E Partin
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Deokumar Srivastava
- Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN
| | - Yutaka Yasui
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN.,Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN.,Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St Jude Children's Research Hospital, Memphis, TN
| |
Collapse
|
10
|
Bortone I, Sardone R, Lampignano L, Castellana F, Zupo R, Lozupone M, Moretti B, Giannelli G, Panza F. How gait influences frailty models and health-related outcomes in clinical-based and population-based studies: a systematic review. J Cachexia Sarcopenia Muscle 2021; 12:274-297. [PMID: 33590975 PMCID: PMC8061366 DOI: 10.1002/jcsm.12667] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 10/30/2020] [Accepted: 12/16/2020] [Indexed: 12/20/2022] Open
Abstract
Aging is often associated with a decline in physical function that eventually leads to loss of autonomy in activities of daily living (ADL). Walking is a very common ADL, important for main determinants of quality of life in older age, and it requires the integration of many physiological systems. Gait speed has been described as the 'sixth vital sign' because it is a core indicator of health and function in aging and disease. We reviewed original studies up to June 2020 that assessed frailty in both longitudinal and cross-sectional observational studies, paying particular attention to how gait is measured in older population and how the gait parameter adopted may influence the estimated frailty models and the health-related outcomes of the various studies (i.e. clinical, cognitive, physical, and nutritional outcomes). Eighty-five studies met the search strategy and were included in the present systematic review. According to the frailty tools, more than 60% of the studies used the physical phenotype model proposed by Fried and colleagues, while one-third referred to multi-domain indexes or models and only 5% referred to other single-domain frailty models (social or cognitive). The great heterogeneity observed in gait measurements and protocols limited the possibility to directly compare the results of the studies and it could represent an important issue causing variability in the different outcome measures in both clinical-and population-based settings. Gait appeared to be an indicator of health and function also in frail older adults, and different gait parameters appeared to predict adverse health-related outcomes in clinical, cognitive, and physical domains and, to a lesser extent, in nutritional domain. Gait has the potential to elucidate the common basic mechanisms of cognitive and motor decline. Advances in technology may extend the validity of gait in different clinical settings also in frail older adults, and technology-based assessment should be encouraged. Combining various gait parameters may enhance frailty prediction and classification of different frailty phenotypes.
Collapse
Affiliation(s)
- Ilaria Bortone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Rodolfo Sardone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Luisa Lampignano
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Fabio Castellana
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Roberta Zupo
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Madia Lozupone
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Biagio Moretti
- Orthopaedics and Trauma Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| | - Gianluigi Giannelli
- Scientific DirectionNational Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
| | - Francesco Panza
- Population Health Unit – “Salus In Apulia Study”National Institute of Gastroenterology “Saverio de Bellis”, Research HospitalCastellana Grotte, BariItaly
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense OrgansUniversity of Bari Aldo MoroBariItaly
| |
Collapse
|
11
|
Nitrini R, Bucki SMD, Yassuda MS, Fichman HC, Caramelli P. The Figure Memory Test: diagnosis of memory impairment in populations with heterogeneous educational background. Dement Neuropsychol 2021; 15:173-185. [PMID: 34345358 PMCID: PMC8283874 DOI: 10.1590/1980-57642021dn15-020004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 04/19/2021] [Indexed: 12/02/2022] Open
Abstract
Diagnosis of cognitive impairment is usually difficult in low-educated individuals. The Brief Cognitive Screening Battery (BCSB) was designed as a screening tool for the evaluation of cognitive impairment in low-educated individuals, but it may also be used for evaluating individuals with high educational level. OBJECTIVES To perform a narrative review analyzing the origin of the BCSB, to report all studies that have used the Figure Memory Test (FMT) of the BCSB, and to demonstrate that it is a useful battery for regions where populations have heterogeneous educational background. METHODS We performed a search in PubMed, SciELO, and LILACS using the terms "Brief Cognitive Screening Battery" and "Brief Cognitive Battery". RESULTS We obtained 49 papers from PubMed, 32 from SciELO, and 28 from LILACS. After the exclusion of duplicate papers, 54 publications were obtained; five more studies were included from previous knowledge of the authors. Twenty-four papers were related to the impact of education on performance, diagnostic accuracy, cutoff scores and normative studies. The delayed recall of the FMT showed the best accuracy for the diagnosis of dementia with a cutoff score of ≤5 in different education levels. In 35 papers, the FMT of the BCSB was used in clinical studies with different settings, from outpatient memory clinics to epidemiological studies and evaluation of Amazon river basin dwelling individuals, and it was always considered to be easy to apply. CONCLUSIONS The FMT of the BCSB is an easy and short tool for the diagnosis of dementia in populations with heterogeneous educational background.
Collapse
Affiliation(s)
- Ricardo Nitrini
- Department of Neurology, Faculdade de Medicina, Universidade de São Paulo ‒ São Paulo, SP, Brazil
| | | | - Mônica Sanches Yassuda
- Department of Neurology, Faculdade de Medicina, Universidade de São Paulo ‒ São Paulo, SP, Brazil
- Gerontology, School of Arts, Sciences and Humanities, Universidade de São Paulo ‒ São Paulo, SP, Brazil
| | - Helenice Charchat Fichman
- Department of Psychology, Pontifícia Universidade Católica do Rio de Janeiro ‒ Rio de Janeiro, RJ, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Group, Faculdade de Medicina, Universidade Federal de Minas Gerais ‒ Belo Horizonte, MG, Brazil
| |
Collapse
|
12
|
Alqahtani BA, Alenazi AM, Alshehri MM, Osailan AM, Alsubaie SF, Alqahtani MA. Prevalence of frailty and associated factors among Saudi community-dwelling older adults: a cross-sectional study. BMC Geriatr 2021; 21:185. [PMID: 33731034 PMCID: PMC7972196 DOI: 10.1186/s12877-021-02142-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 03/09/2021] [Indexed: 11/11/2022] Open
Abstract
Background Prevalence of frailty has been previously established in different Western countries; however, the prevalence and the burden of in the aging populations of Saudi Arabia has not been examined. Therefore, the aim of this study was to examine the prevalence of frailty, and associated factors among Saudi older population. Methods The study included a total of 486 community-dwelling elderly adults aged 60 years and over living in the Riyadh area. This study took place from August 2019 to June 2020. The prevalence of frailty was determined using the Fried’s frailty phenotype. Association between sociodemographic features and clinical factors and frailty was estimated by Odds Ratio and confidence intervals (OR, IC 95%) using a multinomial logistic regression model. Results The overall prevalence of pre-frailty and frailty were 47.3 and 21.4%, respectively. The following factors were associated with being frail: age (OR: 6.92; 95%CI 3.11–15.41); living alone (OR: 2.50; 95%CI: 1.12–5.59); had more chronic conditions (OR: 1.96; 95%CI: 1.16–3.30); and cognitive impairment (OR: 7.07; 95%CI: 3.92–12.74). Conclusions The Compared with other populations, the prevalence of frailty and pre-frailty in the Riyadh region of Saudi Arabia was high. The implications of frailty in this population should be discussed in future study.
Collapse
Affiliation(s)
- Bader A Alqahtani
- Department of Health and Rehabilitation sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Kingdom of Saudi Arabia.
| | - Aqeel M Alenazi
- Department of Health and Rehabilitation sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Kingdom of Saudi Arabia
| | - Mohammed M Alshehri
- Physical Therapy Department, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Ahmed M Osailan
- Department of Health and Rehabilitation sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Kingdom of Saudi Arabia
| | - Saud F Alsubaie
- Department of Health and Rehabilitation sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj, 11942, Kingdom of Saudi Arabia
| | | |
Collapse
|
13
|
Rossi PG, Carnavale BF, Farche ACS, Ansai JH, de Andrade LP, Takahashi ACDM. Effects of physical exercise on the cognition of older adults with frailty syndrome: A systematic review and meta-analysis of randomized trials. Arch Gerontol Geriatr 2020; 93:104322. [PMID: 33360014 DOI: 10.1016/j.archger.2020.104322] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 11/23/2020] [Accepted: 12/08/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To analyze the effects of physical exercise on the cognition of community-dwelling older adults with frailty syndrome, through randomized clinical trials. DATA SOURCES Articles published until March 2020 were searched in the databases Science Direct, Scopus, Web of Science, PubMed, Lilacs, Cochrane, IEEE, EMBASE, and SciELO. Search terms included frailty, aged, exercise, rehabilitation, and cognition. For the Portuguese language, equivalent terms were used. STUDY SELECTION Only randomized clinical trials that used physical exercise as an intervention method in community-dwelling older adults (≥ 60y.) with frailty syndrome, and which performed cognitive assessments before and after the intervention were included. DATA EXTRACTION Two authors performed data extraction using predefined data fields. The risk of bias of the six included studies was assessed using the PEDro scale. DATA SYNTHESIS In total, 4501 studies were found. After the selection process, 6 studies were included in the systematic review and 4 studies in the meta-analysis, all with a low risk of bias. The studies included 655 community-dwelling older adults with frailty syndrome. The types of intervention varied, with multicomponent physical exercise being the most frequent. The cognitive assessments were diverse, and the Mini-mental State Examination, Trail Making Test forms A and B, and Digit Span test were the most frequently applied. A meta-analysis was performed with Global Cognition and Trail Making Test forms A and B. The data from the meta-analysis showed that physical exercise improves Global Cognition (Mean Difference = 2.26; 95% CI, 0.42 - 4.09; P = 0.02) and mental flexibility (Trail Making Test B) (Mean Difference = -30.45; 95% CI; - 47.72 - -13.19; P = 0.0005). CONCLUSION Interventions with physical exercise promote benefits in global cognition and mental flexibility of older adults with frailty syndrome.
Collapse
Affiliation(s)
- Paulo Giusti Rossi
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Bianca Ferdin Carnavale
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Ana Claudia Silva Farche
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil
| | - Juliana Hotta Ansai
- Department of Gerontology (DGero), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil; Movement Science Graduate Program, Federal University of Mato Grosso do Sul (UFMS), Campo Grande, MS, Brazil.
| | - Larissa Pires de Andrade
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| | - Anielle Cristhine de Medeiros Takahashi
- Research Laboratory of Older Adults Health (LaPeSI), Department of Physical Therapy (DFisio), Federal University of São Carlos (UFSCar), São Carlos, SP, Brazil.
| |
Collapse
|
14
|
Lorenzo-López L, Blanco-Fandiño J, Cibeira N, Buján A, López-López R, Maseda A, Millán-Calenti JC. Clinical and Neuropsychological Correlates of Prefrailty Syndrome. Front Med (Lausanne) 2020; 7:609359. [PMID: 33240913 PMCID: PMC7680970 DOI: 10.3389/fmed.2020.609359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/20/2020] [Indexed: 12/15/2022] Open
Abstract
Physical frailty is closely associated with cognitive impairment. We aim to investigate the neuropsychological profiles of prefrail and non-frail dementia-free community-dwelling older adults using a comprehensive neuropsychological evaluation, and to examine the association between specific frailty criteria and clinical and neuropsychological scores. Participants completed a comprehensive standardized neuropsychological evaluation (covering cognitive domains such as memory, executive functions, language and attention), and frailty assessment. Frailty was assessed according to biological criteria: unintentional weight loss, exhaustion, low physical activity, slowness, and weakness. The sample comprised 60 dementia-free community-dwelling adults, aged 65 years or older (range 65-89 years; 60.0% women). Forty-two participants were classified as robust (no frailty criteria present), and 18 as prefrail (1 or 2 frailty criteria present). We explored neurocognitive differences between the groups and examined the association between specific criteria of frailty phenotype and clinical and neuropsychological outcomes with bivariate tests and multivariate models. Prefrail participants showed poorer cognitive performance than non-frail participants in both memory and non-memory cognitive domains. However, delayed episodic memory was the only cognitive subdomain that remained significant after controlling for age, gender, and educational level. Gait speed was significantly associated with general cognitive performance, immediate memory, and processing speed, while grip strength was associated with visual episodic memory and visuoconstructive abilities. Both gait speed and grip strength were negatively associated with depressive scores. Our results suggest that prefrailty is associated with cognitive dysfunction. The fact that specific cognitive domains may be susceptible to subclinical states of physical frailty may have important clinical implications. Indeed, early detection of specific cognitive dysfunctions may allow opportunities for reversibility.
Collapse
Affiliation(s)
- Laura Lorenzo-López
- Universidade da Coruña, Gerontology and Geriatrics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Servizo Galego de Saúde (SERGAS), A Coruña, Spain
| | | | | | | | | | | | | |
Collapse
|
15
|
Chu NM, Bandeen-Roche K, Xue QL, Carlson MC, Sharrett AR, Gross AL. Physical Frailty Phenotype Criteria and Their Synergistic Association on Cognitive Functioning. J Gerontol A Biol Sci Med Sci 2020; 76:1633-1642. [PMID: 33057609 DOI: 10.1093/gerona/glaa267] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Frailty (physical frailty phenotype [PFP]) and its criteria (slow gait, weakness, weight loss, low activity, and exhaustion) are each associated with cognitive dysfunction. The extent to which the PFP is associated with cognition beyond that expected from its component parts remains uncertain. METHOD We used the National Health and Aging Trends Study to quantify associations between PFP criteria and cognitive performance (level/change) using adjusted mixed effects models. We tested whether frailty was associated with excess cognitive vulnerability (synergistic/excess effects, Cohen's d) beyond criteria contributions by assessing interactions between each criterion and frailty. RESULTS Among 7439 community-dwelling older adults (mean age = 75.2 years) followed for a mean of 3.2 years (SE = 0.03), 14.1% were frail. The PFP and PFP criteria were all associated with lower baseline cognitive performance, among which slow gait (-0.31 SD, SE = 0.02) and frailty (-0.23 SD, SE = 0.02) were strongest. Only slow gait (-0.03 SD/year, SE = 0.01), frailty (-0.02 SD/year, SE = 0.01), weight loss (-0.02 SD/year, SE = 0.01), and weakness (-0.02 SD/year, SE = 0.01) were associated with cognitive decline. Frailty was associated with cognitive performance above and beyond each criterion (excess effects ranging from -0.07 SD [SE = -0.05] for slow gait to -0.23 SD [SE = 0.03] for weakness); the same was not true for cognitive decline. Slow gait was the only criterion associated with cognitive change among both frail and nonfrail participants (frail: Cohen's d/year = -0.03, SE = 0.01; nonfrail: Cohen's d/year = -0.02, SE = 0.01). CONCLUSIONS PFP is an important frailty measure that is cross-sectionally associated with lower cognitive performance, but not with subsequent cognitive decline, above and beyond its criteria contributions. Further research into the construct of frailty as a "syndrome" correlated with cognition and other adverse outcomes is needed.
Collapse
Affiliation(s)
- Nadia M Chu
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Qian-Li Xue
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Michelle C Carlson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - A Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.,Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
16
|
Fabrício DDM, Chagas MHN, Diniz BS. Frailty and cognitive decline. Transl Res 2020; 221:58-64. [PMID: 32045578 DOI: 10.1016/j.trsl.2020.01.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/16/2020] [Accepted: 01/18/2020] [Indexed: 01/10/2023]
Abstract
Frailty and cognitive impairment are among the 2 most common geriatric syndromes. Their presence poses major risks to the elderly including greater disability, reduced quality of life, and higher morbi-mortality. Recent evidence suggest that frailty can be a risk factor for incident dementia. The opposite is also true since subjects with Alzheimer's disease and other dementia also present with more severe frailty measures. The mechanisms for the association between frailty and cognitive impairment is not clear, but possibly involves abnormalities in biological processes related to aging. Here, we will review the current evidence of the association between frailty and cognitive impairment. We will also review the possible biological mechanistic links between the 2 conditions. Finally, we will address potential therapeutic targets and interventions that can mitigate both conditions.
Collapse
Affiliation(s)
| | - Marcos Hortes N Chagas
- Department of Psychology, Federal University of São Carlos, São Carlos, São Paulo, Brazil; Department of Gerontology, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Breno S Diniz
- Adult Neurodevelopment and Geriatric Psychiatry Division, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Platform for Peripheral Biomarkers Discovery, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
17
|
Leissing-Desprez C, Thomas E, Segaux L, Broussier A, Oubaya N, Marie-Nelly N, Laurent M, Cleret de Langavant L, Fromentin I, David JP, Bastuji-Garin S. Understated Cognitive Impairment Assessed with the Clock-Drawing Test in Community-Dwelling Individuals Aged ≥50 Years. J Am Med Dir Assoc 2020; 21:1658-1664. [PMID: 32387111 DOI: 10.1016/j.jamda.2020.03.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/13/2020] [Accepted: 03/17/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To estimate the prevalence of understated cognitive impairment by administering the Clock-Drawing Test (CDT) to community-dwelling individuals aged ≥50 years and to investigate the associated clinical phenotype. DESIGN A cross-sectional analysis of baseline data on community-dwelling individuals assessed at an outpatient clinic in the Paris region of France. SETTING AND PARTICIPANTS Participants aged ≥50 years (n = 488, median age: 62.1 years) prospectively included in the SUCCessful agEing outpatiEnt's Department survey between 2010 and 2014. METHODS A multidimensional geriatric assessment, including cognition [7-point CDT, Mini-Mental State Examination (MMSE), the 5-word screening test (5-WT), and the Frontal Assessment Battery (FAB)], gait speed in dual tasks, mood [the Geriatric Depression Scale (GDS)], balance, physical functions (gait speed and handgrip strength), nutrition, bone density, and comorbidities; major cardiovascular risk factors, and Scheltens and Fazekas scores on brain magnetic resonance imaging. Baseline characteristics were analyzed as a function of the CDT score (<7 vs 7), using age-adjusted logistic models. RESULTS The prevalence of impairment in the CDT was 23.6%; higher than the values for the MMSE (12.7%), 5-WT (2.3%), and FAB (16.6%). In age-adjusted analyses, a lower educational level (odds ratio [95% confidence interval] = 0.72 [0.58‒0.89]), diabetes (2.57 [1.14‒5.79]), metabolic syndrome (1.93 [1.05‒3.56]), lower gait speed in the cognitive dual task (1.27 [1.05‒1.53]), a poorer Geriatric Depression Scale score (1.86 [1.04‒3.32]), a poorer MMSE score (2.56 [1.35‒4.88]), a poorer FAB score (1.79 [1.01‒3.16]), impaired episodic memory in the 5-WT (4.11 [1.12‒15.02]), and a higher Scheltens score (P = .001) were significantly associated with CDT impairment. CONCLUSIONS AND IMPLICATIONS Understated cognitive impairment is common among young seniors and is associated with factors known to be linked to a higher risk of cognitive decline and dementia. These findings suggest that the CDT may be of value for identifying high-risk individuals who may then benefit from targeted multidomain prevention actions (diet, exercise, cognitive training, and vascular risk factor management).
Collapse
Affiliation(s)
- Claire Leissing-Desprez
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France.
| | - Emilie Thomas
- AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Lauriane Segaux
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Clinical Research Unit (URC Mondor), Creteil, France
| | - Amaury Broussier
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Nadia Oubaya
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Public Health, Creteil, France
| | | | - Marie Laurent
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Laurent Cleret de Langavant
- AP-HP, Hôpitaux Henri-Mondor, Department of Neurology, Creteil, France; INSERM U955 E01, IMRB and ENS-DEC, PSL Research University (NeuroPsychologie Interventionnelle), Creteil and Paris, France
| | - Isabelle Fromentin
- AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Jean-Philippe David
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Geriatric Medecine, Creteil, France
| | - Sylvie Bastuji-Garin
- Univ Paris Est Creteil, INSERM, IMRB, CEpiA Team, Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Clinical Research Unit (URC Mondor), Creteil, France; AP-HP, Hôpitaux Henri-Mondor, Department of Public Health, Creteil, France
| |
Collapse
|
18
|
Hammami S, Zarrouk A, Piron C, Almas I, Sakly N, Latteur V. Prevalence and factors associated with frailty in hospitalized older patients. BMC Geriatr 2020; 20:144. [PMID: 32306905 PMCID: PMC7168944 DOI: 10.1186/s12877-020-01545-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 03/25/2020] [Indexed: 01/28/2023] Open
Abstract
Background Frailty is a multidimensional syndrome that leads to an increase of an age-related disorder of several physiological systems, and cognitive abilities decline. The aim of this study was to evaluate the prevalence of frailty among older persons in Belgium and we examined the factors associated with frailty with a principal focus en cognitive, dietary status, and inflammatory parameters. Methods A total of 124 participants (90 women, 34 men; age: mean ± SD: 85.9 ± 5.5 years) were studied, recruited from the Geriatrics department, Belgium. Nutritional, cognitive status and physical activity were assessed using Mini Mental State Examination score (MMSE), Mini Nutritional Assessment score (MNA), and Katz score, respectively. Frailty syndrome was evaluated using the modified Short Emergency Geriatric Assessment (SEGA) score. Medication and medical history were recorded. Analyzed biochemical parameters included C-reactive protein (CRP), complete blood count, blood creatinine, vitamin D level, and serum protein electrophoresis. According to SEGA score, participants were divided into non-frail (n = 19), frail (n = 25) and severely frail patients (n = 80). Results The SEGA score was inversely correlated with MMSE, MNA and Katz score. SEGA. score was negatively correlated to albumin levels (r = − 0.30; p < 0.001) and positively correlated to CRP, polypharmacy and age (r = 0.28, r = 0.37, r = 0.33 and p < 0.01 respectively). Logistic regression showed a strong association between frailty, Katz score, dementia, polypharmacy and living in nursing home. Conclusion Our results provide useful information for understanding mechanisms of frailty. This will help to develop preventive strategies for the elderly at the pre-frailty stage.
Collapse
Affiliation(s)
- Sonia Hammami
- Department of Internal Medicine CHU F Bourguiba Monastir, Geriatric unit, University Hospital F. Bourguiba, Monastir, Tunisia. .,Biochemistry Laboratory, LR12ES05 LR-NAFS 'Nutrition - Functional Food & Vascular Health'Faculty of Medicine, University of Monastir, Monastir, Tunisia. .,Geriatric Department, GHdC, Charleroi, Belgium.
| | - Amira Zarrouk
- Biochemistry Laboratory, LR12ES05 LR-NAFS 'Nutrition - Functional Food & Vascular Health'Faculty of Medicine, University of Monastir, Monastir, Tunisia.,Biochemistry Laboratory, Faculty of Medicine of Sousse, Sousse, Tunisia
| | | | - Ioana Almas
- Geriatric Department, GHdC, Charleroi, Belgium
| | - Nabil Sakly
- Department of Immunology, CHU F Bourguiba, Monastir, Tunisia
| | | |
Collapse
|
19
|
Sugimoto K, Rakugi H, Kojima T, Ishii S, Akishita M, Tamura Y, Araki A, Kozaki K, Senda K, Fukuoka H, Satake S, Arai H. Chapter 4 Frailty and specific diseases. Geriatr Gerontol Int 2020; 20 Suppl 1:25-37. [PMID: 32050299 DOI: 10.1111/ggi.13833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Ken Sugimoto
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Shinya Ishii
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yoshiaki Tamura
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Atsushi Araki
- Department of Diabetes, Metabolism and Endocrinology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | - Koichi Kozaki
- Department of Geriatric Medicine, Kyorin University, School of Medicine, Mitaka, Japan
| | - Kazuyoshi Senda
- Department of Clinical Research Promotion, Innovation Center for Clinical Research, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hideki Fukuoka
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Shosuke Satake
- Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
| |
Collapse
|
20
|
Brigola AG, Ottaviani AC, Carvalho DHT, Oliveira NA, Souza ÉN, Pavarini SCI. Association between cognitive impairment and criteria for frailty syndrome among older adults. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:2-8. [PMID: 32074186 DOI: 10.1590/0004-282x20190138] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/06/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVE The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. To analyze the association between cognitive impairment and the criteria for frailty. METHODS We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled 'Variables associated to cognition in elderly caregivers' involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. RESULTS Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. CONCLUSION Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty.
Collapse
Affiliation(s)
- Allan Gustavo Brigola
- Universidade Federal de São Carlos, Programa de Pós-Graduação em Enfermagem, São Carlos SP, Brazil
- University of East Anglia, Faculty of Medicine and Health Sciences, United Kingdom
| | - Ana Carolina Ottaviani
- Universidade Federal de São Carlos, Programa de Pós-Graduação em Enfermagem, São Carlos SP, Brazil
| | | | - Nathalia Alves Oliveira
- Universidade Federal de São Carlos, Programa de Pós-Graduação em Enfermagem, São Carlos SP, Brazil
| | - Érica Nestor Souza
- Universidade Federal de São Carlos, Programa de Pós-Graduação em Enfermagem, São Carlos SP, Brazil
| | | |
Collapse
|
21
|
Margioti E, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Vlachos GS, Scarmeas N. Exploring the association between subjective cognitive decline and frailty: the Hellenic Longitudinal Investigation of Aging and Diet Study (HELIAD). Aging Ment Health 2020; 24:137-147. [PMID: 30621435 DOI: 10.1080/13607863.2018.1525604] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Subjective cognitive decline (SCD) refers to self-evaluations of impairment in cognitive functions in the absence of objective deficits. Frailty is a multidimensional syndrome that results in increased vulnerability. Both terms are associated with cognitive decline and increased incidence of dementia. The aim of this study was to explore potential associations between SCD and frailty in elderly individuals.Methods: In this cross-sectional study, we included 1454 participants aged 65 and older from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) study. Individuals with a diagnosis of dementia, mild cognitive impairment, severe anxiety or depression were excluded. SCD were assessed with eighteen questions categorized into cognitive domains. Frailty was assessed according to the Fried definition, the Frailty Index (FI) and the Tilburg Frailty Indicator (TFI). Logistic regression analysis was used to investigate the association.Results: Lower educational level, female sex and low socioeconomic status were found to be associated with frailty and more SCD complaints. Having two or more types of SCD complaints was significantly associated with frailty according to all frailty definitions. All types of SCD complaints were significantly associated with the FI and the TFI. In addition, SCD complaints concerning problems requiring mathematical reasoning had the strongest association with frailty.Conclusion: We found that SCD complaints may be a valid indicator of frailty in cognitively unimpaired older people. We believe that SCD may provide a crucial proactive assessment to detect frailty and to implement programs that will help maintain good health and quality of life during aging.
Collapse
Affiliation(s)
- Eleni Margioti
- Laboratory of Cognitive Neuroscience School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Mary-Helen Kosmidis
- Laboratory of Cognitive Neuroscience School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Diabetics, Harokopio University, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Eva Ntanasi
- Department of Nutrition and Diabetics, Harokopio University, Athens, Greece.,Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - George S Vlachos
- Eginition Hospital, Department of Social Medicine Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- Eginition Hospital, Department of Social Medicine Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| |
Collapse
|
22
|
Brigola AG, Ottaviani AC, Alexandre TDS, Luchesi BM, Pavarini SCI. Cumulative effects of cognitive impairment and frailty on functional decline, falls and hospitalization: A four-year follow-up study with older adults. Arch Gerontol Geriatr 2019; 87:104005. [PMID: 31901850 DOI: 10.1016/j.archger.2019.104005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/08/2019] [Accepted: 12/19/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Evaluate the cumulative effects of cognitive impairment and frailty on functional decline, falls and hospitalization in older adults over a four-year period. METHOD Four hundred five older adults (60-95 years; mean age: 70.62 ± 7.12 years), 57 % female. The frailty evaluation was performed using the clinical criteria of the Cardiovascular Health Study (CHS): weight loss, fatigue, weakness, slowness and low physical activity. Cognitive impairment was defined by cutoff scores of the Mini Mental State Examination (MMSE) based on schooling. Follow-up - functional decline was assessed using the Lawton&Brody scale of instrumental activities of daily living (IADL). An investigation was also performed of the occurrence of falls and admissions to the hospital in the previous twelve months. RESULTS Cognitive impairment was associated with admissions to the hospital and declines in the IADL category of using a telephone. Frailty was associated with admissions to hospital. Cumulative effects were observed for hospitalization and the decline in using the telephone and shopping. Frailty and cognitive impairment increased the risk of being admitted to hospital by 557 % and increased the risk of a decline in using the phone by 262% and shopping by 208%. No conditions were associated with the risk of falls. CONCLUSION The combination of the MMSE and the CHS criteria was adequate for measuring the cumulative effects of cognitive impairment and frailty. Shared physiological mechanisms may explain the relation between cognitive impairment and frailty, but further investigations are needed in Brazil and other low/middle-income countries.
Collapse
Affiliation(s)
- Allan Gustavo Brigola
- Nursing Post-Graduation Program, Federal University of Sao Carlos, Rod. Washington Luís, km 235, SP-310, Sao Carlos, Brazil; School of Health Sciences, University of East Anglia, Norwich Research Park, United Kingdom.
| | - Ana Carolina Ottaviani
- Nursing Post-Graduation Program, Federal University of Sao Carlos, Rod. Washington Luís, km 235, SP-310, Sao Carlos, Brazil.
| | - Tiago da Silva Alexandre
- Department of Gerontology, Federal University of Sao Carlos, Rod. Washington Luís, km 235, SP-310, Sao Carlos, Brazil.
| | - Bruna Moretti Luchesi
- Nursing Post-Graduation Program, Federal University of Mato Grosso do Sul, Distrito Industrial, Tres Lagoas, Brazil.
| | - Sofia Cristina Iost Pavarini
- Department of Gerontology, Federal University of Sao Carlos, Rod. Washington Luís, km 235, SP-310, Sao Carlos, Brazil; Nursing Post-Graduation Program, Federal University of Sao Carlos, Rod. Washington Luís, km 235, SP-310, Sao Carlos, Brazil.
| |
Collapse
|
23
|
FABRÍCIO DAIENEDEMORAIS, ALEXANDRE TIAGODASILVA, CHAGAS MARCOSHORTESNISIHARA. Frailty and cognitive performance in older adults living in the community: a cross-sectional study. ARCH CLIN PSYCHIAT 2019. [DOI: 10.1590/0101-60830000000216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
24
|
Yadav UN, Tamang MK, Thapa TB, Hosseinzadeh H, Harris MF, Yadav KK. Prevalence and determinants of frailty in the absence of disability among older population: a cross sectional study from rural communities in Nepal. BMC Geriatr 2019; 19:283. [PMID: 31640571 PMCID: PMC6806560 DOI: 10.1186/s12877-019-1290-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 09/23/2019] [Indexed: 11/23/2022] Open
Abstract
Background Longevity and frailty have significant implications for healthcare delivery. They increase demands for healthcare service and surge risk of hospitalization. Despite gaining global attention, determinants of frailty have remained unmeasured in the rural community settings in Nepal. This study aimed to address this gap by accessing the prevalence and determinants of frailty in the absence of disability among older population living in rural communities in eastern Nepal. Methods We conducted a cross-sectional analytical study of 794 older adults aged ≥60 living in the rural part of Sunsari and Morang district of eastern Nepal between January and April in 2018. Multi-stage cluster sampling was applied to recruit the study participants. Study measures included socio-demographics; Frail Non-disabled scale (FiND) measuring frailty, Barthel’s Index measuring basic activities of daily living and Geriatric depression scale. Determinants of frailty in the absence of disability were identified using generalized estimating equation (GEE). Results About 65% of the participants self-reported the presence of frailty in the absence of disability. In the adjusted models, those from underprivileged ethnic groups, lack of daily physical exercise, presence of depressive symptoms and those not getting enough social support from family were found to be significantly associated with frailty among older participants. Conclusions The prevalence of frailty in the absence of disability was high among rural community old population living in eastern Nepal. Our findings suggest that need of frailty awareness (both for clinicians and general public), so as to avoid negative consequences. To reduce the healthcare burden early screening frailty in primary care has potentials to prevent implications of frailty in Nepal.
Collapse
Affiliation(s)
- Uday Narayan Yadav
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia. .,Forum for Health Research and Development, Dharan, Nepal.
| | - Man Kumar Tamang
- Forum for Health Research and Development, Dharan, Nepal.,Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | | | | | - Mark Fort Harris
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
| | | |
Collapse
|
25
|
Giusti Rossi P, Pires de Andrade L, Hotta Ansai J, Silva Farche AC, Carnaz L, Dalpubel D, Ferriolli E, Assis Carvalho Vale F, de Medeiros Takahashi AC. Dual-Task Performance: Influence of Frailty, Level of Physical Activity, and Cognition. J Geriatr Phys Ther 2019. [DOI: 10.1519/jpt.0000000000000182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
26
|
Martins NIM, Caldas PR, Cabral ED, Lins CCDSA, Coriolano MDGWDS. Instrumentos de avaliação cognitiva utilizados nos últimos cinco anos em idosos brasileiros. CIENCIA & SAUDE COLETIVA 2019; 24:2513-2530. [DOI: 10.1590/1413-81232018247.20862017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/04/2017] [Indexed: 11/22/2022] Open
Abstract
Resumo A detecção e o monitoramento do déficit cognitivo em idosos são necessários já que podem causar impacto em sua funcionalidade. O objetivo dessa revisão integrativa é analisar a produção científica sobre uso de instrumentos de avaliação cognitiva em idosos brasileiros por meio de artigos publicados nos últimos cinco anos, indexados nas bases de dados Web of Science, PubMed, Scopus e Bireme. Os critérios de inclusão foram: artigos originais publicados em inglês e português, de 2012 a 2016, com critério de idade definido para ser considerado idoso, e escore maior que 6 no CASP adaptado. O critério de exclusão foi: ser resumo de congresso. A amostra final foi composta por 100 artigos. Foram apresentados os 61 instrumentos de avaliação cognitiva utilizados nos estudos, com destaque para o Mini Exame do Estado Mental. Essa revisão apresenta o uso de instrumentos cognitivos na pesquisa brasileira, suas diferentes versões e quais domínios são avaliados. O número de instrumentos presentes na literatura foi amplo. Os mais utilizados foram o MEEM (versão de Brucki e colaboradores), o Teste de Fluência Verbal (categoria animais) e o Teste Span de dígitos (ordem direta e inversa). Os achados apresentados nessa revisão são relevantes não apenas para área da pesquisa observacional e experimental, mas também para a prática clínica.
Collapse
|
27
|
Gifford KA, Bell SP, Liu D, Neal JE, Turchan M, Shah AS, Jefferson AL. Frailty Is Related to Subjective Cognitive Decline in Older Women without Dementia. J Am Geriatr Soc 2019; 67:1803-1811. [PMID: 31095735 DOI: 10.1111/jgs.15972] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 03/14/2019] [Accepted: 04/05/2019] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Physical frailty (or loss of physiologic reserve) is associated with cognitive impairment and dementia. Subjective cognitive decline (SCD) may represent early pathologic changes of dementia. The association between these disease markers is unclear. DESIGN Cross-sectional analysis. SETTING Community-based participants from the Vanderbilt Memory & Aging Project. PARTICIPANTS A total of 306 older adults with normal cognition (NC; n = 174) or mild cognitive impairment (MCI; n = 132). MEASUREMENTS Frailty was measured using standard methods, and a composite frailty score was calculated. SCD was quantified using the Everyday Cognition Scale (ECog; total score and four domain scores). Objective cognition was assessed with the Montreal Cognitive Assessment (MoCA). Proportional odds models, stratified by sex, related the frailty composite to MoCA and total ECog score adjusting for age, education, body mass index, cognitive diagnosis, depressed mood, Framingham Stroke Risk Profile, apolipoprotein E (APOE ε4) carrier status, and height (for gait speed models). Secondary models related individual frailty components to SCD domains and explored associations in NC only. RESULTS In women, frailty composite was related to MoCA (odds ratio [OR] = .56; P = .04), a finding attenuated in sensitivity analysis (OR = .59; P = .08). Frailty composite related to ECog total (OR = 2.27; P = .02), planning (OR = 2.63; P = .02), and organization scores (OR = 2.39; P = .03). Increasing gait speed related to lower ECog total (OR = .06; P = .003) and memory scores (OR = .03; P < .001). Grip strength related to lower ECog planning score (OR = .91; P = .04). In men, frailty was unrelated to objective and subjective cognition (P values >.07). Findings were consistent in the NC group. CONCLUSION Frailty component and composite scores are related to SCD before the presence of overt dementia. Results suggest that this association is present before overt cognitive impairment. Results suggest a possible sex difference in the clinical manifestation of frailty, with primary associations noted in women. Further studies should investigate mechanisms linking early changes among frailty, SCD, and cognition. J Am Geriatr Soc, 1-9, 2019. J Am Geriatr Soc 67:1803-1811, 2019.
Collapse
Affiliation(s)
- Katherine A Gifford
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Susan P Bell
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Dandan Liu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jacquelyn E Neal
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Maxim Turchan
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Avantika S Shah
- Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Center for Quality Aging, Division of General Internal Medicine and Public Health, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Angela L Jefferson
- Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| |
Collapse
|
28
|
Andrade FCD, Corona LP, Oliveira Duarte YA. Educational Differences in Cognitive Life Expectancy Among Older Adults in Brazil. J Am Geriatr Soc 2019; 67:1218-1225. [DOI: 10.1111/jgs.15811] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/18/2018] [Accepted: 01/08/2019] [Indexed: 11/29/2022]
Affiliation(s)
| | - Ligiana Pires Corona
- Department of Nutrition, School of Applied SciencesUniversity of Campinas Campinas Brazil
| | | |
Collapse
|
29
|
Falutz J, Kirkland S, Guaraldi G. Geriatric Syndromes in People Living with HIV Associated with Ageing and Increasing Comorbidities: Implications for Neurocognitive Complications of HIV Infection. Curr Top Behav Neurosci 2019; 50:301-327. [PMID: 31907879 DOI: 10.1007/7854_2019_119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Long-term survival of treated people living with HIV (PLWH) currently approaches that of the general population. The average age of PLWH is currently in the mid-50s in resource-rich countries and is predicted that over 40% of PLWH will be older than 60 within a decade. Similar trends have been confirmed in all communities of PLWH with access to antiretroviral therapies. However, the positive impact on survival has been challenged by several developments. Ageing PLWH have clinical features similar to the general population about 5-10 years older. In addition to the earlier occurrence of common age-related conditions common geriatric syndromes have also impacted this population prematurely. These are often difficult to evaluate and manage conditions usually of multifactorial aetiology. They include polypharmacy, frailty, impaired mobility and falls, sarcopenia, sensory impairment, and increasingly, non-dementing cognitive decline. Cognitive decline is of particular concern to PLWH and their care providers. In the general geriatric population cognitive impairment increases with age and occurs in all populations with a prevalence of over 25% in people over 80. Effective treatments are lacking and therefore minimizing risk factors plays an important role in maintaining healthspan. In the general population geriatric syndromes may increase the risk of cognitive decline. The corollary is that decreasing the risk of their development may limit cognitive impairment. Whether a similar status holds in PLWH is uncertain. This chapter will address the question of whether common geriatric syndromes in PLWH contribute to cognitive impairment. Common risk factors may provide clues to limit or delay cognitive decline.
Collapse
Affiliation(s)
- Julian Falutz
- McGill University Health Centre, Montreal, QC, Canada.
| | | | | |
Collapse
|
30
|
Lourenço RA, Moreira VG, Banhato EFC, Guedes DV, Silva KCAD, Delgado FEDF, Marmora CHC. Prevalência e fatores associados à fragilidade em uma amostra de idosos que vivem na comunidade da cidade de Juiz de Fora, Minas Gerais, Brasil: estudo FIBRA-JF. CIENCIA & SAUDE COLETIVA 2019; 24:35-44. [DOI: 10.1590/1413-81232018241.29542016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 01/28/2017] [Indexed: 12/31/2022] Open
Abstract
Resumo Fragilidade é um estado de vulnerabilidade fisiológica multissistêmica relacionada à idade e a um risco aumentado de desfechos adversos. O objetivo do presente estudo foi avaliar a prevalência e os fatores associados à fragilidade no estudo FIBRA em Minas Gerais, Brasil. Selecionou-se uma amostra aleatória, estratificada por unidade territorial, sexo e idade, de 461 indivíduos, com 65 anos ou mais. A fragilidade foi estabelecida pela presença de três ou mais de cinco itens: sensação de exaustão, baixa força de preensão manual, velocidade da marcha lenta, perda de peso e baixo gasto calórico. A média de idade foi de 74,4 anos (DP± 6,8), 69,6% eram mulheres e 71,9% brancos. A prevalência de fragilidade foi de 5,2%; 49,9% foram de indivíduos pré-frágeis. Idade avançada (OR: 6,4; IC 1,76-23,8), comprometimento das atividades básicas de vida diária (OR: 5,2; IC 1,1-23,1) e auto percepção de saúde ruim (OR: 0,13; IC 0,03-0,4), foram associados à fragilidade. No presente estudo, um número substancial de indivíduos apresentou-se frágil, enquanto que metade da amostra estava sob risco de progressão para esta condição, sugerindo que é urgente a adoção de medidas de saúde pública com objetivo de prevenção e redução de complicações.
Collapse
|
31
|
Paul RH, Cooley SA, Garcia-Egan PM, Ances BM. Cognitive Performance and Frailty in Older HIV-Positive Adults. J Acquir Immune Defic Syndr 2018; 79:375-380. [PMID: 29957675 PMCID: PMC10733865 DOI: 10.1097/qai.0000000000001790] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE This study examined the relative contribution of cognitive status to frailty among older individuals infected with HIV+. DESIGN Participants included 122 HIV+ individuals [mean age = 57.5 (6.6)] with a median CD4 cell count of 546. Undetectable viral load (<50 copies per mL) was observed in 94% of the sample. The sample was defined as frail (n = 21) and nonfrail (n = 101) according to the Fried phenotype criteria. Cognitive tests included measures of executive function, motor/psychomotor, language, learning, and memory. Performances were converted to standardized scores and averaged to calculate individual domain scores and a global index of cognitive function. METHODS Logistic and hierarchical regressions were completed to separately determine the associations between clinical, demographic, and cognitive variables with regards to frailty status. RESULTS Results of the logistic regressions revealed that lower executive function, female sex, and higher symptoms of depression were associated with frailty. The hierarchical analysis revealed no significant contribution of executive function to frailty status after accounting for female sex and symptoms of depression (Nagelkerke R = 0.15). CONCLUSIONS These results emphasize the importance of sex distribution and mental health in explanatory models of frailty in HIV. Further, interventions targeting symptoms of depression may increase resilience in older HIV+ individuals.
Collapse
Affiliation(s)
- Robert H. Paul
- Department of Psychological Sciences, University of Missouri—St. Louis, St. Louis, MO
- Department of Psychological Sciences, Missouri Institute of Mental Health, St. Louis, MO
| | - Sarah A. Cooley
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
| | - Paola M. Garcia-Egan
- Department of Psychological Sciences, University of Missouri—St. Louis, St. Louis, MO
| | - Beau M. Ances
- Department of Neurology, Washington University in St. Louis, St. Louis, MO
- Department of Radiology, Washington University in St. Louis, St. Louis, MO
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO
| |
Collapse
|
32
|
|
33
|
Physical frailty and cognitive function among men with cardiovascular disease. Arch Gerontol Geriatr 2018; 78:1-6. [DOI: 10.1016/j.archger.2018.05.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 03/16/2018] [Accepted: 05/28/2018] [Indexed: 11/24/2022]
|
34
|
Carson RG. Get a grip: individual variations in grip strength are a marker of brain health. Neurobiol Aging 2018; 71:189-222. [PMID: 30172220 DOI: 10.1016/j.neurobiolaging.2018.07.023] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 07/06/2018] [Accepted: 07/29/2018] [Indexed: 02/06/2023]
Abstract
Demonstrations that grip strength has predictive power in relation to a range of health conditions-even when these are assessed decades later-has motivated claims that hand-grip dynamometry has the potential to serve as a "vital sign" for middle-aged and older adults. Central to this belief has been the assumption that grip strength is a simple measure of physical performance that provides a marker of muscle status in general, and sarcopenia in particular. It is now evident that while differences in grip strength between individuals are influenced by musculoskeletal factors, "lifespan" changes in grip strength within individuals are exquisitely sensitive to integrity of neural systems that mediate the control of coordinated movement. The close and pervasive relationships between age-related declines in maximum grip strength and expressions of cognitive dysfunction can therefore be understood in terms of the convergent functional and structural mediation of cognitive and motor processes by the human brain. In the context of aging, maximum grip strength is a discriminating measure of neurological function and brain health.
Collapse
Affiliation(s)
- Richard G Carson
- Trinity College Institute of Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland; School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, UK; School of Human Movement and Nutrition Sciences, The University of Queensland, Australia.
| |
Collapse
|
35
|
Furtado GE, Caldo A, Rieping T, Filaire E, Hogervorst E, Teixeira AMB, Ferreira JP. Physical frailty and cognitive status over-60 age populations: A systematic review with meta-analysis. Arch Gerontol Geriatr 2018; 78:240-248. [PMID: 30029093 DOI: 10.1016/j.archger.2018.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 01/10/2023]
Abstract
The aim of this meta-analysis was to analyse the magnitude of the effect-size of the cognitive status of populations over 60 years of age, when comparing nonfrail versus pre-frail and nonfrail versus frail subgroups. A systematic review of prospective studies published from 2000 to 2017 was completed in Medline, B-on, Ebsco, Ebsco Health, Scielo, ERIC, LILACS and Sport discus databases and observational, cohort and cross-sectional studies were selected. The Mini-Mental State Examination to screening cognitive status and the Fried phenotype for assess physical frailty state was used as clinical outcomes. After applying additional search criteria, 14 manuscripts (26,798 old participants) were selected from an initial universe of 1681 identified. When comparing the scores of cognitive status of the participants who were non-frail (n = 12,729, 47.4%) versus pre-frail (n = 11,559, 43.2%) and non-frail versus frail (n = 2452, 9.4%) subgroups, significant statistical differences were found for both comparisons (M ± SD = 0.60, 95%CI: 0.50-0.62, p < 0.001 and M ± SD = 3.43, 95%CI: 2.26-4.60, p < 0.001, respectively). It is clear that poor cognitive function is strongly closed associated with pre-frailty and frailty subgroups in older populations around the world.
Collapse
Affiliation(s)
- Guilherme Eustáquio Furtado
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| | - Adriana Caldo
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Taís Rieping
- Laboratory of Sport and Exercise Psychology of Faculty of Sport Sciences and Physical Education of University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Edith Filaire
- CIAMS, University Paris-Sud, Université, Paris-Saclay, 91405, Orsay Cedex, France; CIAMS, Université d'Orléans, 45067, Orléans, France; Research Team ECRIN, INRA, UMR 1019, Clermont-Ferrand, France; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Ana Maria Botelho Teixeira
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal
| | - José Pedro Ferreira
- Research Unit of Physical Activity and Sport at Faculty of Sport Sciences and Physical Education (CIDAF, UID/PDT/04213/2016) - University of Coimbra, Portugal; Medical Psychology Unit, School of Medicine, Clinical Neuroscience and Mental Health, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
| |
Collapse
|
36
|
Sobral AIGDP, de Araújo CMT, Sobral MFF. Mild cognitive impairment in the elderly Relationship between communication and functional capacity. Dement Neuropsychol 2018; 12:165-172. [PMID: 29988360 PMCID: PMC6022979 DOI: 10.1590/1980-57642018dn12-020009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 04/10/2018] [Indexed: 11/21/2022] Open
Abstract
Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. OBJECTIVE To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. METHODS A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody's Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. RESULTS There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). CONCLUSION Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.
Collapse
|
37
|
Jayakody DMP, Friedland PL, Martins RN, Sohrabi HR. Impact of Aging on the Auditory System and Related Cognitive Functions: A Narrative Review. Front Neurosci 2018; 12:125. [PMID: 29556173 PMCID: PMC5844959 DOI: 10.3389/fnins.2018.00125] [Citation(s) in RCA: 92] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 02/15/2018] [Indexed: 12/15/2022] Open
Abstract
Age-related hearing loss (ARHL), presbycusis, is a chronic health condition that affects approximately one-third of the world's population. The peripheral and central hearing alterations associated with age-related hearing loss have a profound impact on perception of verbal and non-verbal auditory stimuli. The high prevalence of hearing loss in the older adults corresponds to the increased frequency of dementia in this population. Therefore, researchers have focused their attention on age-related central effects that occur independent of the peripheral hearing loss as well as central effects of peripheral hearing loss and its association with cognitive decline and dementia. Here we review the current evidence for the age-related changes of the peripheral and central auditory system and the relationship between hearing loss and pathological cognitive decline and dementia. Furthermore, there is a paucity of evidence on the relationship between ARHL and established biomarkers of Alzheimer's disease, as the most common cause of dementia. Such studies are critical to be able to consider any causal relationship between dementia and ARHL. While this narrative review will examine the pathophysiological alterations in both the peripheral and central auditory system and its clinical implications, the question remains unanswered whether hearing loss causes cognitive impairment or vice versa.
Collapse
Affiliation(s)
- Dona M P Jayakody
- Clinical Research, Ear Science Institute Australia, Subiaco, WA, Australia.,School of Surgery, University of Western Australia, Perth, WA, Australia
| | - Peter L Friedland
- Clinical Research, Ear Science Institute Australia, Subiaco, WA, Australia.,School of Surgery, University of Western Australia, Perth, WA, Australia.,School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia
| | - Ralph N Martins
- Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - Hamid R Sohrabi
- Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| |
Collapse
|
38
|
Amanzio M, Palermo S, Zucca M, Rosato R, Rubino E, Leotta D, Bartoli M, Rainero I. Neuropsychological Correlates of Pre-Frailty in Neurocognitive Disorders: A Possible Role for Metacognitive Dysfunction and Mood Changes. Front Med (Lausanne) 2017; 4:199. [PMID: 29188218 PMCID: PMC5694746 DOI: 10.3389/fmed.2017.00199] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/31/2017] [Indexed: 12/21/2022] Open
Abstract
Background Recent studies have suggested that cognitive functions in patients with neurocognitive disorders have a significant role in the pathogenic mechanisms of frailty. Although pre-frailty is considered an intermediate, preclinical state, epidemiological research has begun to dislodge cognition and frailty into their specific subcomponents to understand the relationship among them. We aim to analyse the possible association between pre-frailty and neuropsychological variables to outline which factors can contribute to minor and major neurocognitive disorders. Methods 60 subjects complaining of different cognitive deficits underwent a deep-in-wide frailty and neuropsychological assessment. We conducted three multiple linear regression analyses adjusted for a combination of demographic measures and involving several neuropsychological–behavioural parameters selected by the literature on physical frailty. Results We found a significant association between frailty—as measured by the multidimensional prognostic index (MPI)—and action monitoring and monetary gain (cognitive domain), depression and disinhibition (behavioural domain). Moreover, an association between MPI and impaired awareness for instrumental activities disabilities exists. Conclusion We propose a novel framework for understanding frailty associated with metacognitive–executive dysfunction.
Collapse
Affiliation(s)
- Martina Amanzio
- Department of Psychology, University of Turin, Turin, Italy.,European Innovation Partnership on Active and Healthy Ageing, Brussels, Belgium
| | - Sara Palermo
- Department of Psychology, University of Turin, Turin, Italy
| | - Milena Zucca
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Rosalba Rosato
- Department of Psychology, University of Turin, Turin, Italy.,Unit of Cancer Epidemiology, "Città della Salute e della Scienza" Hospital and CPO Piemonte, Turin, Italy
| | - Elisa Rubino
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| | | | | | - Innocenzo Rainero
- Department of Neuroscience "Rita Levi Montalcini", University of Turin, Turin, Italy
| |
Collapse
|
39
|
Gonçalves Damascena K, Batisti Ferreira C, Dos Santos Teixeira P, Madrid B, Gonçalves A, Córdova C, de Toledo Nóbrega O, Pimentel Ferreira A. Functional capacity and obesity reflect the cognitive performance of older adults living in long-term care facilities. Psychogeriatrics 2017; 17:439-445. [PMID: 28589705 DOI: 10.1111/psyg.12273] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 03/06/2017] [Accepted: 03/07/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND With the increase in life expectancy, the elderly Brazilian population has grown considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. We analyzed the relationship among cognitive performance, anthropometry, and functional capacity in institutionalized elderly individuals. METHODS In a sample of 38 older adults (20 men, 18 women) aged 73.4 ± 8.1 years, data regarding anthropometric and functional measurements as well as the Mini-Mental State Examination were collected. Functional tests were based on a battery adapted from the Functional Fitness Test. The independent t-test and χ2 test were applied. P < 0.05 was set as the significance threshold. RESULTS The rate of cognitive impairment among obese individuals (78.6%) differed from that among eutrophic subjects (45.8%), but there was no difference between sexes. There was a significant positive correlation between handgrip strength and Mini-Mental State Examination score, and the scores of the timed up-and-go test and the sitting-rising test were negatively correlated with Mini-Mental State Examination score. CONCLUSION Cognitive impairment in the elderly living in long-term care facilities was more pronounced and frequent in obese individuals. This study also demonstrated that better functional capacity reflects better cognitive performance.
Collapse
Affiliation(s)
| | - Cristiane Batisti Ferreira
- Interdisciplinary Center for Research, Integrated Colleges Promove Brasília, Brasília, Brazil.,Graduation Program on Medical Sciences, Faculty of Medicine, University of Brasilia, Brasília, Brazil
| | - Pâmela Dos Santos Teixeira
- Interdisciplinary Center for Research, Integrated Colleges Promove Brasília, Brasília, Brazil.,Group Studies in Exercise Physiology and Health, Catholic University of Brasília, Brasília, Brazil
| | - Bibiano Madrid
- Group Studies in Exercise Physiology and Health, Catholic University of Brasília, Brasília, Brazil
| | - Alexandre Gonçalves
- Group Studies in Exercise Physiology and Health, Catholic University of Brasília, Brasília, Brazil
| | - Cláudio Córdova
- Graduation Program on Physical Education, Catholic University of Brasília, Brasília, Brazil
| | - Otávio de Toledo Nóbrega
- Graduation Program on Medical Sciences, Faculty of Medicine, University of Brasilia, Brasília, Brazil
| | - Aparecido Pimentel Ferreira
- Interdisciplinary Center for Research, Integrated Colleges Promove Brasília, Brasília, Brazil.,Group Studies in Exercise Physiology and Health, Catholic University of Brasília, Brasília, Brazil.,Graduation Program on Physical Education, Catholic University of Brasília, Brasília, Brazil
| |
Collapse
|
40
|
The relation of education, occupation, and cognitive activity to cognitive status in old age: the role of physical frailty. Int Psychogeriatr 2017; 29:1469-1474. [PMID: 28539130 DOI: 10.1017/s1041610217000795] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND It remains unclear so far whether the role of cognitive reserve may differ between physically frail compared to less frail individuals. Therefore, the present study set out to investigate the relation of key markers of cognitive reserve to cognitive status in old age and its interplay with physical frailty in a large sample of older adults. METHODS We assessed Mini-Mental State Examination (MMSE) in 701 older adults. We measured grip strength as indicator of physical frailty and interviewed individuals on their education, past occupation, and cognitive leisure activity. RESULTS Greater grip strength, longer education, higher cognitive level of job, and greater engaging in cognitive leisure activity were significantly related to higher MMSE scores. Moderation analyses showed that the relations of education, cognitive level of job, and cognitive leisure activity to MMSE scores were significantly larger in individuals with lower, compared to those with greater grip strength. CONCLUSIONS Cognitive status in old age may more strongly depend on cognitive reserve accumulated during the life course in physically frail (compared to less frail) older adults. These findings may be explained by cross-domain compensation effects in vulnerable individuals.
Collapse
|
41
|
Kucharska-Newton AM, Palta P, Burgard S, Griswold ME, Lund JL, Capistrant BD, Kritchevsky SB, Bandeen-Roche K, Windham BG. Operationalizing Frailty in the Atherosclerosis Risk in Communities Study Cohort. J Gerontol A Biol Sci Med Sci 2017; 72:382-388. [PMID: 27470301 DOI: 10.1093/gerona/glw144] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/08/2016] [Indexed: 11/13/2022] Open
Abstract
Background Factors that may contribute to the development of frailty in late life have not been widely investigated. The Atherosclerosis Risk in Communities (ARIC) Study cohort presents an opportunity to examine relationships of midlife risk factors with frailty in late life. However, we first present findings on the validation of an established frailty phenotype in this predominantly biracial population of older adults. Methods Among 6,080 participants, we defined frailty based upon the Cardiovascular Health Study (CHS) criteria incorporating measures of weight loss, exhaustion, slow walking speed, low physical activity, and low grip strength. Criterion and predictive validity of the frailty phenotype were estimated from associations between frailty status and participants' physical and mental health status, physiologic markers, and incident clinical outcomes. Results A total of 393 (6.5%) participants were classified as frail and 50.4% pre-frail, similar to CHS (6.9% frail, 46.6% pre-frail). In age-adjusted analyses, frailty was concurrently associated with depressive symptoms, low self-rated health, low medication adherence, and clinical biomarker levels (ie, cholesterol, hemoglobin A1c, white blood cell count, C-reactive protein, and hemoglobin). During 1-year follow-up, frailty was associated with falls, low physical ability, fatigue, and mortality. Conclusions These findings support the validity of the CHS frailty phenotype in the ARIC Study cohort. Future studies in ARIC may elucidate early-life exposures that contribute to late-life frailty.
Collapse
Affiliation(s)
- Anna M Kucharska-Newton
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill
| | - Priya Palta
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill
| | - Sheila Burgard
- Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill
| | - Michael E Griswold
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Jennifer L Lund
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill
| | | | - Stephen B Kritchevsky
- Division of Gerontology and Geriatric Medicine, Department of Medicine, Wake Forest University, Winston-Salem, North Carolina
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - B Gwen Windham
- Department of Medicine, University of Mississippi Medical Center, Jackson
| |
Collapse
|
42
|
Mauthner O, Claes V, Deschodt M, Jha SR, Engberg S, Macdonald PS, Newton PJ, De Geest S. Handle with care: A systematic review on frailty in cardiac care and its usefulness in heart transplantation. Transplant Rev (Orlando) 2017; 31:218-224. [DOI: 10.1016/j.trre.2017.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 01/10/2023]
|
43
|
Furtado G, Patrício M, Loureiro M, Teixeira AM, Ferreira JP. Physical Fitness and Frailty Syndrome in Institutionalized Older Women. Percept Mot Skills 2017; 124:754-776. [DOI: 10.1177/0031512517709915] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Guilherme Furtado
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
| | - Miguel Patrício
- Laboratory of Biostatistics and Medical Informatics and IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Marisa Loureiro
- Laboratory of Biostatistics and Medical Informatics and IBILI, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Ana Maria Teixeira
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
| | - José Pedro Ferreira
- Research Unit for Sport and Physical Activity (CIDAF) at Faculty of Sport Science and Physical Education (FCDEF), Coimbra, Portugal
| |
Collapse
|
44
|
Ferriolli E, Pessanha FPADS, Moreira VG, Dias RC, Neri AL, Lourenço RA. Body composition and frailty profiles in Brazilian older people: Frailty in Brazilian Older People Study-FIBRA-BR. Arch Gerontol Geriatr 2017; 71:99-104. [PMID: 28395196 DOI: 10.1016/j.archger.2017.03.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 01/25/2017] [Accepted: 03/25/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine the association between body composition and frailty in older Brazilian subjects. MATERIAL AND METHODS This is a Cross-sectional study called FIBRA-BR and developed in community Brazilian aged ≥65 (n=5638). Frailty was assessed according to Fried et al. definition and body composition was determined by BMI, waist circumference and waist-hip ratio. RESULTS The lowest prevalence of frailty was observed in subjects with BMI between 25.0 and 29.9kg/m2. Subjects with a BMI <18.5 and those with elevated WC presented a higher risk of frailty compared to eutrophic subjects (odds ratio (OR)=3.10; 95% CI: 2.06-4.67) and (OR=1.15; 95% CI: 1.03-1.27), respectively. Being overweight was protective for pre-frailty (OR=0.48; 95% CI: 0.4-0.58) and frailty (OR=0.77; 95% CI: 0.67-0.9). Obese older people presented a higher risk of pre-frailty only (OR=1.29; 95% CI: 1.09-1.51). Older people with high WC showed a greater proportion of frailty regardless of the BMI range. CONCLUSION Undernutrition is associated with pre-frailty and frailty in Brazilian elderly subjects, whereas obesity is associated only with pre-frailty. Overweight seems to have a protective effect against the syndrome. The excess of abdominal fat is associated with both profiles independent of the BMI.
Collapse
Affiliation(s)
- Eduardo Ferriolli
- Division of General Internal and Geriatric Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.
| | | | - Virgílio Garcia Moreira
- GeronLab, Internal Medicine Department, Health Science School, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.
| | - Rosângela Corrêa Dias
- Division of Physiotherapy, School of Physiotherapy, Minas Gerais Federal University, Belo Horizonte, MG, Brazil.
| | - Anita Liberalesso Neri
- Department of Internal Medicine, Faculty of Medical Sciences, Campinas State University, Campinas, SP, Brazil.
| | - Roberto Alves Lourenço
- GeronLab, Internal Medicine Department, Health Science School, Rio de Janeiro State University, Rio de Janeiro, RJ, Brazil.
| |
Collapse
|
45
|
Mauthner O, Claes V, Walston J, Engberg S, Binet I, Dickenmann M, Golshayan D, Hadaya K, Huynh-Do U, Calciolari S, De Geest S. ExplorinG frailty and mild cognitive impairmEnt in kidney tRansplantation to predict biomedicAl, psychosocial and health cost outcomeS (GERAS): protocol of a nationwide prospective cohort study. J Adv Nurs 2016; 73:716-734. [DOI: 10.1111/jan.13179] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Oliver Mauthner
- Institute of Nursing Science; University of Basel; Switzerland
| | - Veerle Claes
- Institute of Nursing Science; University of Basel; Switzerland
| | - Jeremy Walston
- Center on Aging and Health; Johns Hopkins University; Baltimore Maryland USA
| | - Sandra Engberg
- Institute of Nursing Science; University of Basel; Switzerland
- School of Nursing; University of Pittsburgh; Pennsylvania USA
| | - Isabelle Binet
- Clinic of Nephrology and Transplantation Medicine; Cantonal Hospital St Gallen; Switzerland
| | - Michael Dickenmann
- Department for Transplantation-Immunology and Nephrology; University Hospital Basel; Switzerland
| | - Déla Golshayan
- Transplantation Centre and Transplantation Immunopathology Laboratory; University Hospital Lausanne; Switzerland
| | - Karine Hadaya
- Department of Nephrology; University Hospital Geneva; Switzerland
| | - Uyen Huynh-Do
- University Clinic for Nephrology, Hypertension and Clinical Pharmacology; University Hospital Bern; Switzerland
| | | | - Sabina De Geest
- Institute of Nursing Science; University of Basel; Switzerland
- Academic Center for Nursing and Midwifery; KU Leuven; Belgium
| | | |
Collapse
|
46
|
Silva N, Menezes TND. [The association between cognition and handgrip strength among the elderly: an integrative review]. CIENCIA & SAUDE COLETIVA 2016; 21:3611-3620. [PMID: 27828593 DOI: 10.1590/1413-812320152111.22872015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 01/16/2016] [Indexed: 12/25/2022] Open
Abstract
The objective of this study is to identify researches that associated cognition and handgrip strength among the elderly. This is a bibliographic review, based on an integrative approach of articles published in the last five years, indexed in the PubMed, Lilacs and Scopus databases. Inclusion criteria were: observational or experimental studies with a sample of elderly people (aged 60 years or more); assessment of muscular strength using a manual dynamometer; seniors who had at least one cognitive assessment instrument. At the end of the search 10 articles were selected to examine cognitive function and statistical results in the sample. It was observed that most of the research was conducted among the elderly aged over 75 and the Mini Mental State Examination (MMSE) was identified as the scale most commonly used for global cognitive assessment. A significant association was identified between alterations in cognition and reduction of handgrip strength (HGS) in 90% of the articles included in this study. Results of this review suggest the influence of cognitive impairment on the muscular strength of the elderly, which can affect aspects of their functional capacity and consequent dependence.
Collapse
Affiliation(s)
- Nathalie Silva
- Conselho de Ensino, Pesquisa e Extensão, Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário. 58109-753 Campina Grande PB Brasil.
| | - Tarciana Nobre de Menezes
- Conselho de Ensino, Pesquisa e Extensão, Universidade Estadual da Paraíba. Av. das Baraúnas 351, Campus Universitário. 58109-753 Campina Grande PB Brasil.
| |
Collapse
|
47
|
Gray WK, Richardson J, McGuire J, Dewhurst F, Elder V, Weeks J, Walker RW, Dotchin CL. Frailty Screening in Low- and Middle-Income Countries: A Systematic Review. J Am Geriatr Soc 2016; 64:806-23. [PMID: 27100577 DOI: 10.1111/jgs.14069] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES To conduct a systematic review of frailty screening tools used in low- and middle-income countries (LMICs). DESIGN Systematic review. SETTING LMICs, as defined by the World Bank on June 30, 2014. PARTICIPANTS Elderly adults (as defined by the authors) living in LMICs. MEASUREMENTS Studies were included if the population under consideration lived in a LMIC, the study involved an assessment of frailty, the study population was elderly adults, and the full text of the study was available in English. The Medline, Embase, CINAHL and PsychINFO databases were searched up to June 30, 2014. RESULTS Seventy studies with data from 22 LMICs were included in the review. Brazil, Mexico, and China provided data for 60 of the 70 studies (85.7%), and 15 countries contributed data to only one study. Thirty-six studies used the Fried criteria to assess frailty, 20 used a Frailty Index, and eight used the Edmonton Frailty Scale; none of the assessment tools used had been fully validated for use in a LMIC. CONCLUSION There has been a rapid increase in the number of published studies of frailty in LMICs over the last 5 years. Further validation of the assessment tools used to identify frail elderly people in LMICs is needed if they are to be efficient in identifying those most in need of health care in such settings.
Collapse
Affiliation(s)
- William K Gray
- Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Jenny Richardson
- Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Jackie McGuire
- Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | | | - Vasanthi Elder
- Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Julie Weeks
- Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom
| | - Richard W Walker
- Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.,Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Catherine L Dotchin
- Northumbria Healthcare National Health Service Foundation Trust, North Tyneside General Hospital, North Shields, United Kingdom.,Institute for Ageing, Newcastle University, Newcastle upon Tyne, United Kingdom
| |
Collapse
|
48
|
Panza F, Seripa D, Solfrizzi V, Tortelli R, Greco A, Pilotto A, Logroscino G. Targeting Cognitive Frailty: Clinical and Neurobiological Roadmap for a Single Complex Phenotype. J Alzheimers Dis 2016; 47:793-813. [PMID: 26401761 DOI: 10.3233/jad-150358] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Late-life cognitive disorders may be prevented by influencing age-related conditions such as frailty, characterized by decreased resistance to stressors and increased risk for adverse health outcomes. In the present review article, we examined clinical and epidemiological studies investigating the possible role of different frailty models in modulating the risk of Alzheimer's disease (AD), dementia, vascular dementia (VaD), mild cognitive impairment (MCI), and late-life cognitive impairment/decline that have been published over the past 3 years. Both deficit accumulation and physical frailty models were associated with late-life cognitive impairment/decline, incident dementia, AD, MCI, VaD, non-AD dementias, and AD pathology, proposing cognitive frailty as a new clinical construct with coexisting physical frailty and cognitive impairment in nondemented older subjects. Two subtypes of this new clinical condition have been recently proposed: "potentially reversible" cognitive frailty and "reversible" cognitive frailty. The physical factors should be physical prefrailty and frailty, while the cognitive impairment of potentially reversible cognitive frailty should be MCI (Clinical Dementia rating Scale = 0.5), while the cognitive impairment of reversible cognitive frailty should be pre-MCI Subjective Cognitive Decline (SCD), as recently proposed by the SCD Initiative Working Group. The mechanisms underlying the cognitive-frailty link are multifactorial and vascular, inflammatory, nutritional, and metabolic influences may be of major relevance. Considering both physical frailty and cognition as a single complex phenotype may be crucial in the prevention of dementia and its subtypes with secondary preventive trials on cognitive frail older subjects.
Collapse
Affiliation(s)
- Francesco Panza
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy.,Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Davide Seripa
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Vincenzo Solfrizzi
- Geriatric Medicine-Memory Unit and Rare Disease Centre, University of Bari Aldo Moro, Bari, Italy
| | - Rosanna Tortelli
- Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| | - Antonio Greco
- Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy
| | - Alberto Pilotto
- Geriatrics Unit, Department of OrthoGeriatrics, Rehabilitation and Stabilization, Frailty Area, Galliera Hospital NR-HS, Genova, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.,Department of Clinical Research in Neurology, University of Bari Aldo Moro, "Pia Fondazione Cardinale G. Panico", Tricase, Lecce, Italy
| |
Collapse
|
49
|
Kelaiditi E, Canevelli M, Andrieu S, Del Campo N, Soto ME, Vellas B, Cesari M. Frailty Index and Cognitive Decline in Alzheimer's Disease: Data from the Impact of Cholinergic Treatment USe Study. J Am Geriatr Soc 2016; 64:1165-70. [DOI: 10.1111/jgs.13956] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Eirini Kelaiditi
- Gérontopôle; Centre Hospitalier Universitaire de Toulouse; Toulouse France
| | - Marco Canevelli
- Gérontopôle; Centre Hospitalier Universitaire de Toulouse; Toulouse France
- Memory Clinic; Department of Neurology and Psychiatry; “Sapienza” University; Rome Italy
| | - Sandrine Andrieu
- Gérontopôle; Centre Hospitalier Universitaire de Toulouse; Toulouse France
- Unité Mixte de Recherche 1027; Institut National de la Santé et de la Recherche Médicale; Toulouse France
- Université de Toulouse III Paul Sabatier; Toulouse France
- Department of Public Health; Centre Hospitalier Universitaire de Toulouse; Toulouse France
| | - Natalia Del Campo
- Gérontopôle; Centre Hospitalier Universitaire de Toulouse; Toulouse France
| | - Maria E. Soto
- Gérontopôle; Centre Hospitalier Universitaire de Toulouse; Toulouse France
- Unité Mixte de Recherche 1027; Institut National de la Santé et de la Recherche Médicale; Toulouse France
| | - Bruno Vellas
- Gérontopôle; Centre Hospitalier Universitaire de Toulouse; Toulouse France
- Unité Mixte de Recherche 1027; Institut National de la Santé et de la Recherche Médicale; Toulouse France
- Université de Toulouse III Paul Sabatier; Toulouse France
| | - Matteo Cesari
- Gérontopôle; Centre Hospitalier Universitaire de Toulouse; Toulouse France
- Unité Mixte de Recherche 1027; Institut National de la Santé et de la Recherche Médicale; Toulouse France
- Université de Toulouse III Paul Sabatier; Toulouse France
| | | |
Collapse
|
50
|
Kang JY, Kim CH, Sung EJ, Shin HC, Shin WJ, Jung KH. The Association between Frailty and Cognition in Elderly Women. Korean J Fam Med 2016; 37:164-70. [PMID: 27274387 PMCID: PMC4891318 DOI: 10.4082/kjfm.2016.37.3.164] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 09/16/2015] [Accepted: 09/27/2015] [Indexed: 12/20/2022] Open
Abstract
Background Frailty refers to the loss of physiologic complexity and the associated decline in ability to withstand stressors as one gets older. It is defined as unintentional weight loss, exhaustion, weakness, slow walking speed, and low physical activity. According to several western studies, frailty is associated with cognitive impairment, but there have been few studies about the relationship between frailty and cognitive impairment in Korea. Thus, the purpose of this study is to analyze the relationship between cognition and factors related to frailty such as grip strength, walking speed, physical activity, and depression, among female patients older than 65 in Korea. Methods A total of 121 subjects among the outpatients of the department of family medicine at Kangbuk Samsung Hospital who did not meet the exclusion criteria were included in this study. We divided the participants into 2 groups, according to the Korean version of the Montreal Cognitive Assessment (MoCA) score: 1 group with subjects that had normal cognition and the other group with patients that had impaired cognition. A comparison was made between the 2 groups in regards to the factors related to frailty, and we completed equation that predicting cognition from the frailty related factors. Results Compared with the impaired cognition group, the subjects in the normal cognition group had higher hand strength, and walked faster (P<0.001). There was no statistically significant difference in physical activity between the 2 groups (P=0.19). When multiple linear regression analysis was performed using age, grip strength, and walking speed as the predictor variables and MoCA score as the dependent variable, the regression coefficients were calculated to be: -0.2015, 0.2294, 1.2372, and -0.1436, respectively (P<0.05). Conclusion In Korean female patients who are older than 65 years of age, cognition tends to decline as grip strength decreases, walking speed gets slower, depression becomes more severe, and as age increases.
Collapse
Affiliation(s)
- Ji-Young Kang
- Department of the Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Cheol-Hwan Kim
- Department of the Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Ju Sung
- Department of the Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ho-Cheol Shin
- Department of the Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woon-Jung Shin
- Department of the Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keun-Hyeong Jung
- Department of the Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|