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Cozza M, Boccardi V. Cognitive frailty: A comprehensive clinical paradigm beyond cognitive decline. Ageing Res Rev 2025; 108:102738. [PMID: 40122397 DOI: 10.1016/j.arr.2025.102738] [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: 11/04/2024] [Revised: 03/12/2025] [Accepted: 03/17/2025] [Indexed: 03/25/2025]
Abstract
Cognitive frailty is an emerging concept in research and clinical practice that incorporates both physical frailty and mild cognitive impairment (MCI) or subjective cognitive decline (SCD). Unlike traditional approaches that separate physical frailty and dementia, cognitive frailty treats these domains as interrelated and coexisting, with significant implications for clinical outcomes and predicting cognitive decline. Despite growing recognition of this interrelationship, a dualistic view of physical and cognitive processes persists. The paradigm of cognitive frailty holds promise as a biomarker- like amyloid plaques or neurofibrillary tangles- but with the advantage of identifying risk at a prefrail stage, before clinical signs of MCI or dementia emerge. This review examines the pathophysiological and clinical dimensions of cognitive frailty and promotes for its integration into routine assessments in memory clinics.
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Affiliation(s)
- Mariagiovanna Cozza
- UOC Intermediate Care-Long term Budrio Hospital, Ausl Bologna, Integration Department, Italy
| | - Virginia Boccardi
- Division of Gerontology and Geriatrics, Department of Medicine and Surgery, University of Perugia, Santa Maria della Misericordia Hospital, Italy.
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de Araújo RC, Calixtre LB, Gomes WDL, Silva JDDA, Maranhão DCM, Angelo FDDA, Santos GLLDS, Amaral KMS, Gonçalves RLDS, de Alencar JG, Callisaya ML, Trombini-Souza F, Pitangui ACR. Longitudinal Analysis of Intrinsic Capacity and Other Risk Factors in Aging: FREVO Study Protocol. Healthcare (Basel) 2025; 13:993. [PMID: 40361771 PMCID: PMC12071889 DOI: 10.3390/healthcare13090993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2025] [Revised: 04/16/2025] [Accepted: 04/21/2025] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Population aging presents important global and socio-economic challenges, especially in developing countries such as Brazil, where aging is projected to accelerate in the next years. This manuscript presents the protocol of the FREVO (risk factors in aging) study, a six-year longitudinal study that aims to assess intrinsic capacity and its interaction with other risk factors. Moreover, this study aims to evaluate the combination of these factors and their correlation with major adverse health outcomes among community-dwelling older adults in Petrolina, Brazil. Methods: This six-year prospective cohort study will recruit 496 participants aged 60 or older. Annual in-person assessments using validated tools will measure intrinsic capacity, personal information, lifestyle, and chronic conditions. Negative outcomes (falls, hospitalizations, dementia, and death) will be recorded biannually by phone. Statistical analyses will employ latent profile analysis to identify risk phenotypes and Cox regression models for time-to-event analyses. Results: This study will attempt to identify phenotypes and modifiable risk factors by using the WHO's intrinsic capacity framework in a low-resource Brazilian context for the assessment and promotion of healthy aging. Conclusions: Our findings will address important gaps that can contribute to a localized understanding of aging, aligning global frameworks with regional realities to promote independence, functionality, and quality of life for older adults.
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Affiliation(s)
- Rodrigo Cappato de Araújo
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
- Department of Physical Therapy, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Letícia Bojikian Calixtre
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Wildja de Lima Gomes
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Juliana Daniele de Araújo Silva
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Diógenes Candido Mendes Maranhão
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Fernando Damasceno de Albuquerque Angelo
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Gabriel Lucas Leite da Silva Santos
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Késia Moreira Sampaio Amaral
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Ruth Lahis da Silva Gonçalves
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Julia Gomes de Alencar
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
| | - Michele L. Callisaya
- National Centre for Healthy Ageing, Melbourne, VIC 3199, Australia;
- Peninsula Clinical School, Central Clinical School, Monash University, Frankston, VIC 3199, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7005, Australia
| | - Francis Trombini-Souza
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
- Department of Physical Therapy, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
| | - Ana Carolina Rodarti Pitangui
- Graduate Program of Rehabilitation and Functional Performance, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil; (L.B.C.); (W.d.L.G.); (J.D.d.A.S.); (D.C.M.M.); (F.D.d.A.A.); (G.L.L.d.S.S.); (K.M.S.A.); (R.L.d.S.G.); (J.G.d.A.); (F.T.-S.); (A.C.R.P.)
- Department of Physical Therapy, University of Pernambuco (UPE), Petrolina 56328-900, PE, Brazil
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Zhu Z, Xue H, Huang C, Zhang J, Tu J, Ling K, Gu D. Association of malnutrition with cognitive frailty in China: a systematic review and meta-analysis. Front Public Health 2025; 13:1567372. [PMID: 40297025 PMCID: PMC12034679 DOI: 10.3389/fpubh.2025.1567372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2025] [Accepted: 03/31/2025] [Indexed: 04/30/2025] Open
Abstract
Background With an aging population, China faces a growing burden of age-related health conditions, including cognitive frailty and malnutrition. This study aimed to investigate the current status of malnutrition in individuals with cognitive frailty in China and to assess the association between the two conditions. Methods We conducted a comprehensive search of databases including PubMed, Web of Science, Scopus, Embase, Cochrane Library, CNKI, Wanfang, and Weipu up to April 26, 2024. Meta-analysis was performed using Stata/MP 16, with sensitivity and subgroup analyses to explore heterogeneity, and Begg's and Egger's tests to assess publication bias, applying the trim-and-fill method for correction. Results Of 2,077 records, 19 were included. The pooled prevalence of cognitive frailty was 26% (95% confidence interval [CI]: 0.17-0.36, p < 0.01), and the prevalence of malnutrition was 45% (95% CI, 0.30-0.58, p < 0.01). A significant association was identified between cognitive frailty and malnutrition (odds ratio [OR] = 4.23, 95% CI: 2.56-6.99, p < 0.001), adjusted to OR = 3.00 (95% CI, 1.87-4.80) post-correction. Conclusion Malnutrition is prevalent among individuals with cognitive frailty in China. Given its higher prevalence in community settings than in hospitals, early screening and specific interventions are crucial to address this issue.
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Affiliation(s)
- Zhiren Zhu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Huiping Xue
- Nursing Department, Affiliated Hospital of Nantong University, Nantong, China
| | - Chunxia Huang
- Nursing Department, Affiliated Hospital of Nantong University, Nantong, China
| | - Jie Zhang
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Jinheng Tu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Kenan Ling
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
| | - Dongmei Gu
- School of Nursing and Rehabilitation, Nantong University, Nantong, China
- Nursing Department, Affiliated Hospital of Nantong University, Nantong, China
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Huang Y, Zhao D, Yang Z, Wei C, Qiu X. The relationship between VAI, LAP, and depression and the mediation role of sleep duration-evidence from NHANES 2005-2020. BMC Psychiatry 2025; 25:228. [PMID: 40069662 PMCID: PMC11899296 DOI: 10.1186/s12888-025-06631-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2024] [Accepted: 02/19/2025] [Indexed: 03/14/2025] Open
Abstract
BACKGROUND The relationship between obesity and mental health has attracted attention. However, large sample studies on the relationship between visceral fat obesity and depression are lacking. This study aimed to explore the relationship between visceral fat obesity and depression by using visceral adiposity index (VAI) and lipid accumulation product (LAP). Additionally, it sought to explore the potential mediating role of sleep duration in these associations. METHODS The data used in the current cross-sectional investigation are from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2020, including 19,659 participants. Depression was measured using the nine-item Patient Health Questionnaire. Weighted multivariable regression analysis was used to evaluate the correlation of VAI and LAP with depression. The potential non-linear relationship was determined using smooth curve fitting and threshold effect analysis. Additionally, mediation analysis was performed to investigate the potential mediating role of sleep duration. The stability of the relationship was assessed through sensitivity analysis. RESULTS VAI and LAP were closely related to depression. In the fully adjusted model, VAI and LAP in the highest quartile increased the association of depression by 52% (OR = 1.52, 95% CI 1.20-1.92, P < 0.001) and 51% (OR = 1.51, 95% CI 1.19-1.91, P < 0.001), respectively, compared with the lowest quartile. Specific saturation effects for VAI, LAP, and depression were identified by smoothed curve fitting, with inflection points of 3.81 and 98.55, respectively. Additionally, mediation analysis revealed that 5.1% and 2.8% of the associations between VAI and LAP with depression were mediated through sleep duration. The results of the sensitivity analysis showed interactions between hypertension and cardiovascular disease in the associations of VAI, and depression (P < 0.05). CONCLUSION VAI and LAP are associated with depression in US adults. The associations between VAI and LAP with depression are non-linear, which may be mediated through sleep duration. The study highlights the potential of VAI and LAP as valuable tools for the prevention and management of depression.
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Affiliation(s)
- Yiqing Huang
- Medical School, Shenzhen University, No.1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhongfang Yang
- School of Nursing, Fudan University, 305 Fenglin Road, Shanghai, 200032, China
| | - Changning Wei
- School of Tech X Academy, Shenzhen Polytechnic University, Shenzhen, China
| | - Xichenhui Qiu
- Medical School, Shenzhen University, No.1066, Xueyuan Avenue, Nanshan District, Shenzhen, Guangdong Province, 518060, People's Republic of China.
- Rory Meyers College of Nursing, New York University, New York, NY, 10010, USA.
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Gou D, Min C, Peng X, Wu H, Zhang L, Chen Y, Tao M. Associating factors of cognitive frailty among older people with chronic heart failure: Based on LASSO-logistic regression. J Adv Nurs 2025; 81:1399-1411. [PMID: 39078209 DOI: 10.1111/jan.16352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 06/10/2024] [Accepted: 07/08/2024] [Indexed: 07/31/2024]
Abstract
AIM To analyse factors associated with cognitive frailty among older chronic heart failure patients in China. DESIGN A cross-sectional design. METHODS Between August 2021 and November 2022, a total of 421 chronic heart failure patients (age ≥60 years) were randomly selected from the cardiology department of the affiliated hospital of Zunyi Medical University. The FRAIL scale, Mini-Mental State Examination, 15-item Geriatric Depression Scale, Social Support Rating Scale, Short-form Mini Nutritional Assessment and Pittsburgh Sleep Quality Index were utilized for measurement and evaluation. The demographic and clinical characteristics of patients were collected. To select initial variables, the Least Absolute Shrinkage Selection Operator was applied, and then logistic regression analysis was used to confirm associating factors. RESULTS Among 421 elderly people with chronic heart failure, 83 cases (19.7%) showed cognitive frailty. Of 31 variables, seven were selected by Least Absolute Shrinkage Selection Operator regression. Finally, multivariate logistic regression revealed that the age, monthly salary, drinking, NYHA classification, length of hospital stay, depression and malnutrition risk/malnutrition were independently associated with cognitive frailty. CONCLUSION The high proportion of cognitive frailty in older people with chronic heart failure should be concerned. Additionally, in the setting of cognitive frailty, efforts to diagnose it and develop interventions to prevent or reverse cognitive frailty status among older chronic heart failure patients are necessary. IMPACT The findings of our study highlight the necessity to evaluate cognitive frailty in older people with chronic heart failure and provide a new perspective and scientific basis for medical staff to develop individualized and specific interventions to prevent or reverse cognitive frailty status. REPORTING METHOD This study has been reported in compliance with STROBE reporting guidelines for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
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Affiliation(s)
- Dengqun Gou
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Changhang Min
- Department of Laboratory Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Xiaofeng Peng
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Hemei Wu
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Lu Zhang
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Yu Chen
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
| | - Ming Tao
- Department of Nursing, Affiliated Hospital of Zunyi Medical University, Zunyi, P. R. China
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Yuan Y, Wang S, Zhou C, Zhang A, Zhang S, Wang Y. Effects of exercise interventions on cognition, physical function and quality of life among older adults with cognitive frailty: A systematic review and meta-analysis. Geriatr Nurs 2025; 62:96-107. [PMID: 39889512 DOI: 10.1016/j.gerinurse.2025.01.006] [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: 06/04/2024] [Revised: 12/16/2024] [Accepted: 01/16/2025] [Indexed: 02/03/2025]
Abstract
OBJECTIVES To explore the effects of exercise interventions on cognition, physical function, and quality of life among older adults with cognitive frailty. METHODS A systematic review and meta-analysis were conducted (PROSPERO [CRD42024532608]). PubMed, Web of Science, Cochrane Library, Embase, CNKI, WanFang, VIP, and SinoMed databases were searched from inception until December 18, 2023. RESULTS We found exercise improved overall cognition, physical frailty, walking ability, gait speed, and so on among older adults with cognitive frailty, but the effect on physical fitness and quality of life was insignificant. Subgroup analysis revealed exercise conducted ≥3 times per week, each session lasting ≤45 min and cycle≤12 weeks, had better-improved cognition. Traditional mind-body exercises like Baduanjin were more effective than resistance training for enhancing cognition. CONCLUSIONS Exercise intervention benefits overall cognition and most physical functions, but its impact on physical fitness and quality of life remains to be confirmed by future studies.
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Affiliation(s)
- Yue Yuan
- School of Nursing, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei Province, China
| | - Sixue Wang
- School of Nursing, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei Province, China
| | - Chunyi Zhou
- School of Nursing, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei Province, China
| | - Ailin Zhang
- School of Nursing, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei Province, China
| | - Shibo Zhang
- School of Nursing, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei Province, China
| | - Yuncui Wang
- School of Nursing, Hubei University of Traditional Chinese Medicine, Wuhan, Hubei Province, China; Engineering Research Center of TCM Protection Technology and New Product Development for the Elderly Brain Health, Ministry of Education, Wuhan, Hubei Province, China; Hubei Shizhen Laboratory, Wuhan, Hubei Province, China.
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Zheng L, Li X, Xu Y, Yang Y, Wan X, Ma X, Yao G, Li G. Effects of Virtual Reality-Based Activities of Daily Living Rehabilitation Training in Older Adults With Cognitive Frailty and Activities of Daily Living Impairments: A Randomized Controlled Trial. J Am Med Dir Assoc 2025; 26:105397. [PMID: 39615543 DOI: 10.1016/j.jamda.2024.105397] [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: 09/10/2024] [Revised: 10/31/2024] [Accepted: 11/02/2024] [Indexed: 12/14/2024]
Abstract
OBJECTIVES Cognitive frailty, which is notably prevalent in nursing homes, correlates with a range of adverse health outcomes; however, interventions targeting this population are scarce, particularly those addressing activities of daily living (ADLs). The objective of this study was to evaluate the effects of virtual reality-based ADL rehabilitation training on older adults with cognitive frailty and ADL impairments. DESIGN A 2-arm randomized controlled trial. SETTING AND PARTICIPANTS Older adults with cognitive frailty and mild ADL impairments in a nursing home. METHODS Sixty-six eligible participants were equally randomized into intervention and control groups. The intervention involved 45-minute sessions conducted twice weekly for 12 weeks. Outcomes evaluated included ADL performance, cognition, frailty, depression, and quality of life. Assessments were performed at baseline, 6 weeks (T1), and 12 weeks (T2). RESULTS There was no statistically significant difference between the 2 groups at baseline. The mean age of the participants was 80.20 ± 9.14 years, and most were women (54.55%). Compared with the control group, the intervention group showed significant improvements in ADLs (T1: β = 6.33, T2: β = 12.79), basic ADLs (T1: β = 4.09, T2: β = 6.97), instrumental ADLs (T1: β = 2.24, T2: β = 4.12), cognition (T1: β = 3.67, T2: β = 4.42), frailty (T1: β = -0.76, T2: β = -1.27), and mental component summary of quality of life (T1: β = 8.49, T2: β = 16.44) at T1 and T2. By T2, significant improvements were observed in depression (T2: β = -2.06) and physical component summary of quality of life (T2: β = 8.52). CONCLUSIONS AND IMPLICATIONS For older adults with cognitive frailty and mild ADL impairments residing in a nursing home, the virtual reality-based ADL rehabilitation program was safe and effective. Following the 12-week intervention, significant improvements were observed in ADL performance, cognition, frailty, depression, and quality of life.
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Affiliation(s)
| | - Xin Li
- School of Nursing, Gansu University of Chinese Medicine, Lanzhou, China
| | - Yiran Xu
- School of Nursing, Jilin University, Changchun, China
| | - Yali Yang
- School of Nursing, Jilin University, Changchun, China
| | - Xinyu Wan
- School of Nursing, Jilin University, Changchun, China
| | - Xuehan Ma
- School of Nursing, Jilin University, Changchun, China
| | - Gengxin Yao
- School of Nursing, Jilin University, Changchun, China
| | - Guichen Li
- School of Nursing, Jilin University, Changchun, China.
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Qin T, Fan C, Liu Q, Wang J, Zhu X. Development and validation of a nomogram for predicting cognitive frailty in patients on maintenance haemodialysis. J Adv Nurs 2025; 81:834-847. [PMID: 38807450 DOI: 10.1111/jan.16253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 04/10/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
AIMS This study aimed to construct a nomogram for predicting the risk of cognitive frailty in patients on maintenance haemodialysis. DESIGN An explorative cross-sectional design was adopted. METHODS From April 2022 to July 2022, 496 participants were recruited from five haemodialysis centres in Qingdao, Shandong Province, China. Participants with cognitive frailty were screened by Frailty Phenotype scale and Mini-Mental State Examination. Least Absolute Shrinkage and Selection Operator (LASSO) regression and multivariate logistic regression were utilized to determine predictors. The predictive performance of the nomogram was validated by calibration and discrimination. Decision curve analysis was used to assess clinical utility. Internal validation was implemented using 1000 bootstrap samples to mitigate overfitting. RESULTS The prevalence of cognitive frailty was 17.5% (n = 87). Six risk predictors, namely health empowerment, alexithymia, age, educational level, marital status and dialysis vintage, were screened and used to develop a nomogram model. The nomogram had satisfactory discrimination and calibration, and decision curve analysis revealed considerable clinical utility. CONCLUSIONS A nomogram incorporated with the six risk predictors was developed, and it exhibited excellent prediction performance. The nomogram may strengthen the effective screening of patients at high risk of cognitive frailty. IMPACT This study established a tool for healthcare staff to predict cognitive frailty probability and identify risk factors in patients on maintenance haemodialysis. The nomogram can meet the needs of personalized care and precision medicine simultaneously. PATIENT OR PUBLIC CONTRIBUTION Data were collected from patients on maintenance haemodialysis by using questionnaire survey. REPORTING METHOD STROBE checklist was used.
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Affiliation(s)
- Tong Qin
- Nursing department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Chun Fan
- Department of Pharmacy, Qingdao Municipal Hospital, Qingdao, Shandong, China
| | - Qingwei Liu
- Nursing department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Jizhe Wang
- Nursing department, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Xiuli Zhu
- School of Nursing, Qingdao University, Qingdao, Shandong, China
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Wang J, Zhu A, Chen J, Zeng R, Wang S, Chen L, Chen Y, Min Q, Li W, Ye D, Wu R, Xie F, Fan T, Zhu K, Zhu W, Hu H, Wang C, Zhang X. Association Between Cognitive Frailty and Depression: A Prospective Cohort Study of Adults Aged 45 Years and Older in China. Clin Interv Aging 2024; 19:2167-2178. [PMID: 39749318 PMCID: PMC11693858 DOI: 10.2147/cia.s484352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 12/22/2024] [Indexed: 01/04/2025] Open
Abstract
Background The interplay between cognitive frailty and depression remains inadequately understood, with a paucity of evidence from prospective cohort studies. Our study aims to elucidate the relationship between cognitive frailty and the risk of incident depression. Methods Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS) spanning 2011, 2013, and 2015, subjects were classified according to cognitive frailty criteria established by an international consensus panel. Multiple logistic regression models were employed to examine the cross-sectional and longitudinal associations between frailty, cognitive impairment, cognitive frailty, and depression. Subgroup analyses and interaction tests were conducted to identify potential effect modifiers. Results In 2011, the study encompassed 4514 participants, with 2330 individuals followed up through 2015. Cross-sectional analyses revealed that participants classified in frailty, cognitive impairment, and cognitive frailty exhibited multivariable-adjusted odds ratios (ORs) for depression of 1.87 (95% CI 1.60-2.18; P < 0.001), 1.97 (95% CI 1.58-2.47; P < 0.001), and 3.38 (95% CI 2.66-4.29; P < 0.001), respectively, compared to no diseased group. Longitudinal analyses from 2011 to 2015 indicated that participants in frailty, cognitive impairment, and cognitive frailty had multivariable-adjusted ORs of 1.28 (95% CI 1.05-1.58; P = 0.0165), 1.39 (95% CI 1.01-1.91; P = 0.0411), and 1.57 (95% CI 1.05-2.35; P = 0.0273), respectively, for new-onset depression relative to no diseased group. Limitations The definition of depression relied solely on self-reported data. Conclusion In the middle-aged and elderly Chinese population, patients with cognitive frailty have a higher risk of depression than those with only frailty and cognitive impairment. This may suggest that health care providers should pay more attention to the mental health of those patients with cognitive frailty.
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Affiliation(s)
- Jiang Wang
- School of Basic Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji’an, Jiangxi, People’s Republic of China
| | - Aizhang Zhu
- School of Basic Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji’an, Jiangxi, People’s Republic of China
| | - Jie Chen
- Department of Emergency, The People’s Hospital of Baoan Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Rui Zeng
- School of Clinical Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Siyi Wang
- School of Basic Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji’an, Jiangxi, People’s Republic of China
| | - Lihuan Chen
- School of Chinese Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Ying Chen
- School of Basic Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji’an, Jiangxi, People’s Republic of China
| | - Qianqian Min
- School of Basic Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji’an, Jiangxi, People’s Republic of China
| | - Wei Li
- School of Clinical Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
- Clinical Medical Research Center, Affiliated Hospital of Jinggangshan University, Jiangxi Province Key Laboratory of Organ Development and Epigenetics, Clinical College of Jinggangshan University, Ji’an, Jiangxi, 343009, People’s Republic of China
| | - Dongmei Ye
- School of Clinical Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Ruohan Wu
- School of Basic Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
- Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch, Ji’an, Jiangxi, People’s Republic of China
| | - Fayi Xie
- School of Clinical Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Tenghui Fan
- School of Clinical Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Ke Zhu
- School of Clinical Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Wan Zhu
- School of Clinical Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Hongmei Hu
- School of Basic Medicine, Jinggangshan University, Ji’an, Jiangxi, People’s Republic of China
| | - Conghua Wang
- Department of Emergency, The People’s Hospital of Baoan Shenzhen, Shenzhen, Guangdong, People’s Republic of China
| | - Xiaoming Zhang
- Department of Emergency, The People’s Hospital of Baoan Shenzhen, Shenzhen, Guangdong, People’s Republic of China
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10
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Qin L, Huang T, Zhang D, Wei L, Li G, Zhu Q, Tong Q, Ding G, Liu J. The mitochondrial function of peripheral blood cells in cognitive frailty patients. Front Aging Neurosci 2024; 16:1503246. [PMID: 39723155 PMCID: PMC11669044 DOI: 10.3389/fnagi.2024.1503246] [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: 09/28/2024] [Accepted: 11/25/2024] [Indexed: 12/28/2024] Open
Abstract
Background Cognitive frailty (CF), characterized by the coexistence of physical frailty and cognitive impairment, is linked to increased morbidity and mortality in older adults. While CF has been linked to multiple physiological and lifestyle factors, the underlying biological mechanisms remain poorly understood. This study investigated the risk factors for CF and explored the relationship between mitochondrial function and CF in hospitalized patients. Methods A total of 279 hospitalized individuals were recruited from December 2020 to August 2022, conducted comprehensive clinical assessments, and collected peripheral blood samples. CF was evaluated using the Physical Frailty Phenotype and Montreal Cognitive Assessment scales. Nutritional status was assessed with the Mini Nutritional Assessment, and depression was measured using the Geriatric Depression Scale. DNA was obtained from the peripheral blood and interrogated for mitochondrial DNA copy number (mtDNAcn). Peripheral blood mononuclear cells isolated from peripheral blood were examined for respiratory function and reactive oxygen species (ROS) levels. Additionally, plasma samples were analyzed for inflammatory markers and Carnitine Palmitoyltransferase II (CPT2). Results Among the participants, 90 were classified as CF and 46 as non-CF. Logistic regression analysis revealed that increased age (OR 1.156, 95% CI 1.064-1.255), lower educational attainment (OR 0.115, 95% CI 0.024-0.550), malnutrition (OR 0.713, 95% CI 0.522-0.973), and higher depression scores (OR 1.345, 95% CI 1.065-1.699) were significantly associated with CF. The independent t tests and Mann-Whitney U tests showed the CF group exhibited impaired mitochondrial function, characterized by reduced mtDNAcn and respiratory activity, coupled with elevated ROS, interleukin-6, and CPT2 levels compared with the non-CF group. After adjusted for age, sex, and BMI, compared with non-CF group, the OR values for the CF group of mtDNAcn and ROS were 0.234 (95% CI = 0.065-0.849) (p = 0.027) and 1.203 (95% CI = 1.075-1.347) (p = 0.001), respectively. The Sensitive analysis showed that the area under curve values for mtDNAcn and ROS were 0.653 and 0.925. Conclusion Age, lower educational attainment, malnutrition, and depression are significant risk factors for CF. Moreover, mitochondrial dysfunction, characterized by decreased mtDNAcn, impaired respiratory function and increased ROS levels appears to be a critical phenotype of CF.
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Affiliation(s)
| | | | | | | | | | | | | | - Guoxian Ding
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Juan Liu
- Division of Geriatric Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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11
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Chen S, Chen T, Honda T, Kishimoto H, Nofuji Y, Narazaki K. Cognitive frailty and functional disability in older adults: A 10-year prospective cohort study in Japan. GeroScience 2024:10.1007/s11357-024-01461-0. [PMID: 39627573 DOI: 10.1007/s11357-024-01461-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Accepted: 11/25/2024] [Indexed: 03/26/2025] Open
Abstract
Cognitive frailty is considered a clinical entity associated with a high risk for adverse health outcomes. However, its clinical significance remains poorly understood. This study investigated the association between cognitive frailty and risk for functional disability among community-dwelling older adults. In total, 1,597 Japanese adults aged ≥ 65 years that were free of dementia and functional disability at baseline were prospectively followed for 10 years. Cognitive frailty was defined as the presence of both physical frailty (using Cardiovascular Health Study criteria) and cognitive impairment (Mini-Mental State Examination score < 26 points). Functional disability was identified using Japan's Long-term Care Insurance System database. Cox proportional hazard models were used to estimate the hazard ratios (HR) for cognitive frailty on the risk for functional disability. Functional disability was identified in 488 participants during follow-up. A multiplicative interaction effect between cognitive impairment and physical frailty on the risk of disability was observed (p = 0.045). Compared with the robust group, the multivariable-adjusted HRs (95% confidence interval) for functional disability were 3.70 (2.37‒5.77) for cognitive frailty, 2.51 (1.81‒3.47) for physical pre-frailty with cognitive impairment, 2.16 (1.42‒3.29) for cognitive impairment only, 1.95 (1.36‒2.80) for physical frailty only, and 1.94 (1.53‒2.46) for physical pre-frailty only. These associations remained after adjusting for the competing risk for death and in sensitivity analyses to minimize potential reverse causality. Cognitive frailty is associated with an increased risk for functional disability in community-dwelling older adults. Cognitive frailty may be a clinically important target for the prevention of functional disability.
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Affiliation(s)
- Sanmei Chen
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Minami Ward, 1-2-3 Kasumi, Hiroshima, 734-8551, Japan
| | - Tao Chen
- Sports and Health Research Center, Department of Physical Education, Tongji University, 1239 Siping Road, Shanghai, 200-092, China
| | - Takanori Honda
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Hiro Kishimoto
- Faculty of Arts and Science, Kyushu University, 744 Motooka Nishi-Ku, Fukuoka, 819-0395, Japan
| | - Yu Nofuji
- Research Team for Social Participation and Healthy Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, 35-2 Sakae, Itabashi, Tokyo, 173-0015, Japan
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of Technology, 3-30-1 Wajiro-Higashi, Higashi-Ku, Fukuoka, 811-0295, Japan.
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12
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Luo H, Zheng Z, Yuan Z, Hu H, Sun C. The effectiveness of multicomponent exercise in older adults with cognitive frailty: a systematic review and meta-analysis. Arch Public Health 2024; 82:229. [PMID: 39614334 DOI: 10.1186/s13690-024-01441-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 10/31/2024] [Indexed: 12/01/2024] Open
Abstract
BACKGROUND Cognitive frailty, intimately tied to adverse outcomes such as falls, early mortality, and hospitalization, represents a dynamic, reversible process. Multicomponent exercise has emerged as one of the most potent means of mitigating cognitive frailty. AIMS This research seeks to quantitively amalgamate the effects of multicomponent exercise on various domains: cognitive function, frailty status, and other health-related outcomes in cognitively frail older adults. METHODS Our methodology entailed a comprehensive review of literature in databases including PubMed, EMbase, CINAHL, Cochrane Library, Web of Science, Wanfang, Sinomed, VIP, and CNKI from the inception of these databases to December 10, 2023. For our statistical analysis, we utilized RevMan 5.3, Stata 17.0 and R 4.3.2 software. Adherence was maintained to the PRISMA checklist, with the study being registered with PROSPERO (CRD42024499808). RESULTS Our review encapsulated a total of 2,222 participants and 11 trials. The findings intimate that multicomponent exercise enhances cognitive function [MD = 2.52, p = 0.03]), grip strength[SMD = 0.39, p = 0.008] and lower limb muscle strength[MD = 4.30, p < 0.001], while alleviating frailty[MD = -2.21, p < 0.001] and depression [MD = -1.20, p = 0.001]. However, cogent evidence is still lacking to endorse the positive effects of multicomponent exercises on both ADL(p = 0.19) and quality of life(p = 0.16). Subgroup analyses revealed beneficial effects on cognitive frailty for multicomponent exercise whose type of exercise consisted of aerobic, the duration of which exceeded 120 min per week, and whose form of exercise was group exercise. CONCLUSION Multicomponent exercises offer significant improvements in cognitive function, muscle strength, and have the added benefit of reducing frailty and depression in older adults. However, these exercises do not appear to influence activities of daily living and quality of life positively.
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Affiliation(s)
- Huanhuan Luo
- Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of MedicalSciences and Peking Union Medical College, Beijing, People's Republic of China
- Department of Nursing, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Science, NO.1 Da Hua Road, DongDan, Beijing, 100730, People's Republic of China
| | - Zitian Zheng
- Department of Sports MedicineInstitute of Sports Medicine of Peking UniversityBeijing Key Laboratory of Sports Injuries, Peking University Third Hospital, Beijing, People's Republic of China
- Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, People's Republic of China
| | - Zhe Yuan
- Department of Orthopedics, the Fourth Medical Centre, Chineses PLA General Hospital, 51 Fucheng Road, Beijing, 100048, People's Republic of China.
| | - Huixiu Hu
- Department of Nursing, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Science, NO.1 Da Hua Road, DongDan, Beijing, 100730, People's Republic of China.
| | - Chao Sun
- Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of MedicalSciences and Peking Union Medical College, Beijing, People's Republic of China.
- Department of Nursing, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Science, NO.1 Da Hua Road, DongDan, Beijing, 100730, People's Republic of China.
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13
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Gao J, Bai D, Chen H, Chen X, Luo H, Ji W, Hou C. Risk factors analysis of cognitive frailty among geriatric adults in nursing homes based on logistic regression and decision tree modeling. Front Aging Neurosci 2024; 16:1485153. [PMID: 39640422 PMCID: PMC11617544 DOI: 10.3389/fnagi.2024.1485153] [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: 08/23/2024] [Accepted: 11/07/2024] [Indexed: 12/07/2024] Open
Abstract
Objective To investigate the risk factors associated with cognitive frailty among older adults in nursing homes using logistic regression and decision tree modeling, and to compare the predictive performance of these methods. Methods A cross-sectional study was conducted involving 697 participants aged 60 and older residing in eight nursing homes in Sichuan province, China. Participants were recruited using convenience sampling. Data were collected through questionnaires administered to the older adults. Logistic regression and decision tree modeling were employed to construct models predicting cognitive frailty. Results Logistic regression analysis identified age, education degree, exercise, intellectual activities, number of chronic diseases, nutritional status, sleep quality, and depression as significant predictors of cognitive frailty (all p < 0.05). The final decision tree model consisted of three layers and 17 nodes. Six factors were identified as significant predictors: sleep quality, number of chronic diseases, depression, education level, nutrition, and exercise. Receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) for the logistic regression model was 0.735 (95% CI: 0.701-0.767) with a sensitivity of 0.58 and specificity of 0.75. The AUC for the decision tree model was 0.746 (95% CI: 0.712-0.778) with a sensitivity of 0.68 and specificity of 0.70. Conclusion Age, education level, exercise, intellectual activities, sleep quality, number of chronic diseases, nutritional status, and depression are significant risk factors for cognitive frailty in older adults residing in nursing homes. Both logistic regression and decision tree models demonstrated comparable predictive performance, with each offering distinct advantages. The combined use of these methods can enhance predictive accuracy and provide valuable insights for clinical practice and policy development.
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Affiliation(s)
| | | | | | | | | | - Wenting Ji
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chaoming Hou
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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14
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Li W, Tian Q, Duan J, Liu X, Shou J, Tang T, Yu W, Lü Y. Frailty increases depression risk independently of cognitive decline: Insights from Mendelian randomization and cross-sectional analysis. Exp Gerontol 2024; 197:112603. [PMID: 39366459 DOI: 10.1016/j.exger.2024.112603] [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: 08/11/2024] [Revised: 09/22/2024] [Accepted: 09/28/2024] [Indexed: 10/06/2024]
Abstract
BACKGROUND Frailty, cognitive decline, and depression are common syndromes among the elderly and are closely interconnected. However, it is still unclear whether the impact of frailty on depression depends on the role of cognitive decline. METHOD We conducted the Mendelian randomization (MR) analysis based on the instrumental variables (IVs) from the genome-wide association study (GWAS) databases, and we also performed a cross-sectional study consisting of 1362 older adults aged ≥65 for validation. RESULTS The results of the multivariable MR analysis showed that frailty significantly increased the risk of depression, even after controlling for the influence of cognitive performance. Conversely, after controlling for frailty, the effect of cognitive performance on depression risk was noticeably reduced. In the cross-sectional study, frailty mediated 24.04 % of the relationship between cognition and depression, and cognition mediated 7.63 % of the relationship between frailty and depression. CONCLUSIONS We provide evidence that frailty could increase depression risk independently of cognitive decline. Further research with a larger sample size is necessary.
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Affiliation(s)
- Wenjie Li
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Qi Tian
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jingxi Duan
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Xintong Liu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Jianwei Shou
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Ting Tang
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
| | - Weihua Yu
- Department of Human Anatomy, Institute of Neuroscience, Chongqing Medical University, Chongqing 400016, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China.
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Fang J, Liang H, Chen M, Zhao Y, Wei L. Association of preoperative cognitive frailty with postoperative complications in older patients under general anesthesia: a prospective cohort study. BMC Geriatr 2024; 24:851. [PMID: 39427111 PMCID: PMC11491029 DOI: 10.1186/s12877-024-05431-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 10/03/2024] [Indexed: 10/21/2024] Open
Abstract
BACKGROUND Cognitive frailty (CF) is characterized by the coexistence of physical frailty and cognitive impairment, and it is associated with adverse health outcomes. Older adults are particularly vulnerable to CF due to factors such as age-related brain changes and the presence of comorbidities. OBJECTIVE To investigate the effect of preoperative CF on postoperative complications in older patients. METHODS This prospective cohort study was conducted among 253 patients aged 60-85 years, who underwent elective orthopedic and abdominal surgery (with a postoperative hospital stay of ≥ 3 days) at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2023 to November 2023. CF was assessed using the Montreal Cognitive Assessment (MoCA) for the cognitive status and the Fried criteria for five frailty scales. Participants were split into four groups: Group A (neither frailty nor cognitive impairment), Group B (frailty without cognitive impairment), Group C (cognitive impairment without frailty), and Group D (cognitive frailty). The primary outcome was postoperative complications, while secondary outcomes included mobility disability, prolonged hospital stay (PLOS), re-operation and 90-day readmission. RESULTS The median age (interquartile range) of participants was 69 (65-73) years, of which 40.3% were male. The prevalence of CF was 17.8%. The incidence of postoperative complications was 18.2% in Group A, 50.0% in Group B, 37.4% in Group C, and 75.6% in Group D. Multivariate analysis revealed that, compared to the control group (without cognitive impairment or frailty), patients with CF had a significantly higher risk of postoperative complications (OR, 12.86; 95%CI, 4.23-39.08). "Patients with frailty without cognitive impairment" had an increased risk (OR, 6.53; 95%CI, 2.04-20.9), while "those with cognitive impairment without frailty" also showed a higher risk (OR, 3.46; 95%CI, 1.57-7.64). CONCLUSIONS Cognitive frailty is significantly associated with an increased risk of postoperative adverse outcomes in older patients undergoing orthopedic and abdominal surgeries with general anesthesia. It indicates that clinicians should pay much attention to these older adults with CF.
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Affiliation(s)
- Jiamin Fang
- The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Hao Liang
- Department of Nursing, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510120, China
| | - Muxin Chen
- Department of Pulmonary and Critical Care Medicine Ward 1, Qingyuan Hospital Affiliated to Guangzhou Medical University (Qingyuan People 's Hospital), Qingyuan, 511518, China
| | - Yidi Zhao
- College of Nursing, Hunan University of Traditional Chinese Medicine, Changsha, 410208, China
| | - Lin Wei
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Department of Nursing, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese medicine, Dade Road 111, Yuexiu District, Guangzhou, Guangdong, 510120, China.
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16
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Qi X, Kong H, Li J, Chen C. The relationship between insomnia and multidimensional frailty in community-dwelling older adults: A systematic review. Arch Gerontol Geriatr 2024; 129:105661. [PMID: 39427528 DOI: 10.1016/j.archger.2024.105661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 09/24/2024] [Accepted: 10/13/2024] [Indexed: 10/22/2024]
Abstract
OBJECTIVE To examine the relationship between insomnia and multidimensional frailty among community-dwelling older adults. METHOD We conducted a comprehensive search in the Pubmed, Web of Science, and Embase databases up to May 15, 2024. The included cross-sectional studies were using the Joanna Briggs Institute's Evidence-Based Health Care Center's checklist for analytical cross-sectional studies; the longitudinal study used the Newcastle-Ottawa Scale for risk of bias assessment. RESULTS Out of 1571 studies, 14 were selected. The results indicate a positive relationship between insomnia and cognitive frailty, social frailty, and psychological frailty in community-dwelling older adults. However, the relationship between insomnia and total or physical frailty is unclear. CONCLUSION This study made an association between insomnia and cognitive frailty, social frailty, and psychological frailty in community-dwelling older adults. Due to the limited quality and quantity of the included studies, more high-quality cohort studies are required to verify the above conclusion.
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Affiliation(s)
- Xinghong Qi
- Department of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hui Kong
- Department of Integrated Chinese Medicine Treatment Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China; Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
| | - Jing Li
- Department of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Cui Chen
- Department of Integrated Chinese Medicine Treatment Center, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China; Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China.
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Song Q, Yuan T, Hu Y, Liu X, Fei J, Zhao X, Gao R, Yue J, Mei S. The Effect of Peer Victimization During Adolescence on Depression and Gender Differences: A Systematic Review and Meta-analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:2862-2876. [PMID: 38347760 DOI: 10.1177/15248380241227538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/03/2024]
Abstract
Peer victimization during adolescence has a detrimental impact on the mental health of victims throughout their lives. However, it remains unclear whether these effects are gender-specific. The present study conducted a systematic review to examine the effects of peer victimization on depression status, explore potential sources of heterogeneity, and investigate gender differences in these effects. We systematically searched four electronic databases (Web of Science, PubMed, Embase, and CNKI) for relevant articles that published as far as July 2022. We then extracted odds ratios (OR) and 95% confidence intervals (CI) to assess the association between peer victimization during adolescence and depression, and potential gender differences in the relation. Meta-analysis was performed, using fixed effects models and random effects models, to evaluate the association between each exposure and the outcome. A meta-analysis of 27 studies revealed that peer victimization during adolescence was significantly associated with higher risks of depression (OR = 2.79, 95% CI [2.43, 3.21], p < .001). This finding was consistent across subgroup analyses. In particular, the effect of peer victimization during adolescence on depression was found to be more pronounced in studies conducted in Asia (OR = 3.06, 95% CI [2.38, 3.92], p < .001). Furthermore, five studies focused on gender differences demonstrated that peer victimization has a stronger association with the risk of depression in women (OR = 2.84, 95% CI [2.49, 3.26], p < .001). Peer victimization during adolescence is a significant risk factor for depression, with a greater impact on women and individuals residing in Asia. Further prospective studies are needed to investigate the relationship between peer victimization and depression.
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Affiliation(s)
| | | | | | | | | | | | - Ren Gao
- Jilin University, Changchun, China
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Ren J, Zhang W, Liu Y, Fan X, Li X, Song X. Prevalence of and factors associated with cognitive frailty in elderly patients with chronic obstructive pulmonary disease: A cross-sectional study. Medicine (Baltimore) 2024; 103:e39561. [PMID: 39287286 PMCID: PMC11404930 DOI: 10.1097/md.0000000000039561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 08/09/2024] [Accepted: 08/14/2024] [Indexed: 09/19/2024] Open
Abstract
The status of cognitive frailty in elderly patients with chronic obstructive pulmonary disease (COPD) and its influencing factors in China remains unclear. This study aimed to investigate the prevalence of and factors associated with cognitive frailty in elderly patients with COPD. This cross-sectional study enrolled elderly patients with stable COPD between May and November 2022 from the Respiratory Department of the First Affiliated Hospital of Zhengzhou University and the Fifth Affiliated Hospital of Zhengzhou University. Convenience sampling method was adopted. Frailty Phenotype scale, Montreal Cognitive Assessment scale, Geriatric Depression Scale, and Clinical Dementia Rating scale were used to assess the prevalence of cognitive frailty in elderly patients with COPD. Multivariable logistic regression analysis was used to explore the associated factors. A total of 406 valid questionnaires were collected, and 173 patients (35.6%) had cognitive frailty. Binary logistic regression analysis showed that sex (odds ratio [OR] = 0.009; 95%CI: 0.001-0.770; P = .038), depression (OR = 17.780; 95%CI: 1.092-289.478; P = .043), modified Medical Research Council grade 1-3 (OR = 28.394-4095.683; 95%CI: 1.086-4,592,652.211; P < .05), global initiative for chronic obstructive lung disease grade 2 and 3 (OR = 32.508-282.072; 95%CI: 1.101-12,516.874; P < .05), and frequencies of acute exacerbations of COPD and hospitalizations within 1 year of 2 times (OR = 21.907; 95%CI: 4.587-104.622; P < .001) were independently associated with cognitive frailty. The prevalence of cognitive frailty in elderly patients with stable COPD was high. Female, depression, modified Medical Research Council grade, global initiative for chronic obstructive lung disease grade, and frequencies of acute exacerbations of COPD and hospitalizations within 1 year might be the factors independently associated with cognitive frailty, educational level might be a protective associated factor for cognitive frailty.
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Affiliation(s)
- Jie Ren
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Weihong Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Yanfei Liu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Xin Fan
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Xinxin Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Xinying Song
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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Liang MY, Li R, Feng L, Qian WP. Construction and verification of a risk prediction model for cognitive frailty in older patients with chronic obstructive pulmonary disease and diabetes mellitus. J Int Med Res 2024; 52:3000605241274211. [PMID: 39224937 PMCID: PMC11403697 DOI: 10.1177/03000605241274211] [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] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE We explored risk factors for cognitive frailty in older patients with chronic obstructive pulmonary disease (COPD) and diabetes mellitus to develop and verify a risk prediction model for cognitive frailty. METHODS This was a cross-sectional study. Convenience sampling was used to randomly select 378 patients hospitalized between February 2022 and December 2023. We allocated 265 patients who visited between February 2022 and February 2023 to a modeling group to analyze risk factors for cognitive frailty and create a logistic regression model for risk prediction. Another 113 patients who visited between March 2023 and December 2023 were included in a validation group for model verification. RESULTS The cognitive frailty incidence in the 265 patients was 35.09% (93/265). Regression analysis showed that age >80 years (odds ratio [OR] = 4.576), regular exercise (OR = 0.390, polypharmacy (OR = 3.074), depression (OR = 2.395) duration of COPD combined with diabetes (OR = 1.902), Family APGAR index score (OR = 0.428), and chronic pain (OR = 2.156) were factors influencing the occurrence of cognitive frailty in older patients with COPD accompanied by diabetes. CONCLUSIONS The constructed risk prediction model for cognitive frailty in older patients with COPD and diabetes showed good predictive value, aiding in the clinical identification of high-risk patients and facilitating timely intervention and guidance.
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Affiliation(s)
- Meng-Yao Liang
- Department of Nursing, The Sixth People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Rui Li
- Department of Nursing, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Li Feng
- Department of Nursing, The Sixth People's Hospital of Nantong, Nantong, Jiangsu, China
| | - Wei-Peng Qian
- Department of Nursing, The Sixth People's Hospital of Nantong, Nantong, Jiangsu, China
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20
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Cheng M, Liu Q, Gan H, Liu H, He M. Prevalence and Risk Factors of Cognitive Frailty in Patients Undergoing Maintenance Hemodialysis: A Systematic Review and Meta-Analysis. Semin Dial 2024; 37:363-372. [PMID: 39120010 DOI: 10.1111/sdi.13220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/12/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND The purpose of this study is to investigate the prevalence and risk factor of cognitive frailty in patients undergoing maintenance hemodialysis. METHODS Systematically searched PubMed, EmBase, Web of Science, Cochrane Library, SinoMed, China Knowledge Resource Integrated Database, Wanfang Database, and Weipu Database from inception until January 1, 2024. Two researchers were independently screened and cross-checked. Stata 15.1 software was used to perform the meta-analysis. RESULTS A total of 15 articles were included, including 5398 patients. The results showed that the prevalence of cognitive frailty in patients undergoing maintenance hemodialysis was 24%. Among them, age (odds ratio [OR] = 1.33, 95% CI [1.16, 1.53]), waist circumference (OR = 1.05, 95% CI [1.03, 1.08]), malnutrition (OR = 2.91, 95% CI [1.94, 4.35]), comorbidities (OR = 1.93, 95% CI [1.47, 2.54]), stroke history (OR = 2.94, 95% CI [1.72, 5.03]), and depression (OR = 3.26, 95% CI [1.91, 5.57]) were the main risk factors for cognitive frailty in patients undergoing maintenance hemodialysis. Education level (OR = 0.48, 95% CI [0.31, 0.73]) was protective factors for cognitive frailty in patients undergoing maintenance hemodialysis. CONCLUSIONS Current evidence showed that the prevalence of cognitive frailty in patients undergoing maintenance hemodialysis was high, and there were many risk factors. Therefore, early identification and intervention of cognitive frailty in maintenance hemodialysis patients should be carried out, which may be helpful to reduce the prevalence rate and occurrence of adverse events and improve the prognosis of patients.
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Affiliation(s)
- Min Cheng
- School of Nursing, North Sichuan Medical University, Nanchong, China
- Nursing Department of Mianyang Central Hospital, School of Medicine Affiliated to University of Electronic Science and Technology of China, Mianyang, China
| | - Qin Liu
- School of Nursing, North Sichuan Medical University, Nanchong, China
- Nursing Department of Mianyang Central Hospital, School of Medicine Affiliated to University of Electronic Science and Technology of China, Mianyang, China
| | - Haoyue Gan
- School of Nursing, North Sichuan Medical University, Nanchong, China
- Nursing Department of Mianyang Central Hospital, School of Medicine Affiliated to University of Electronic Science and Technology of China, Mianyang, China
| | - Hangcheng Liu
- School of Nursing, North Sichuan Medical University, Nanchong, China
- Nursing Department of Mianyang Central Hospital, School of Medicine Affiliated to University of Electronic Science and Technology of China, Mianyang, China
| | - Mei He
- Nursing Department of Mianyang Central Hospital, School of Medicine Affiliated to University of Electronic Science and Technology of China, Mianyang, China
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21
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Bai Y, Chen Y, Tian M, Gao J, Song Y, Zhang X, Yin H, Xu G. The Relationship Between Social Isolation and Cognitive Frailty Among Community-Dwelling Older Adults: The Mediating Role of Depressive Symptoms. Clin Interv Aging 2024; 19:1079-1089. [PMID: 38911673 PMCID: PMC11192202 DOI: 10.2147/cia.s461288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/24/2024] [Indexed: 06/25/2024] Open
Abstract
Purpose Social isolation and depression have an impact on cognitive frailty. However, the underlying mechanisms between these variables have not been well defined. This study aims to investigate the mediating role of depressive symptoms in the association between social isolation and cognitive frailty among older adults in China. Methods From Mar 2023 to Aug 2023, a cross-sectional study was conducted with 496 community-dwelling older adults aged ≥60 years in Nanjing, Jiangsu Province, China. Demographic information was collected using the General Information Questionnaire. The Lubben Social Network Scale-6 (LSNS-6), Geriatric Depression Scale 15-item (GDS-15), Montreal Cognitive Assessment (MoCA), Clinical Dementia Rating (CDR), and FRAIL scale were used for the questionnaire survey. Multiple linear regression and binary logistic regression were utilized to explore the associations among social isolation, depressive symptoms, and cognitive frailty, and Bootstrap analysis was used to explore the mediating role of depressive symptoms in social isolation and cognitive frailty. Results Linear regression results revealed that social isolation was positively associated with depressive symptoms (β = 0.873, p < 0.001). Logistic regression analysis showed that social isolation (OR = 1.769, 95% CI = 1.018~3.075) and depressive symptoms (OR = 1.227, 95% CI = 1.108~1.357) were significantly associated with cognitive frailty. Mediation analysis demonstrated that depressive symptoms significantly mediated the relationship between social isolation and cognitive frailty, with an indirect effect of 0.027 (95% CI = 0.003~0.051), and the mediating effect accounted for 23.6% of the total effect. Conclusion Social isolation is associated with cognitive frailty in community-dwelling older adults, and depressive symptoms partially mediate the effect between social isolation and cognitive frailty. Active promotion of social integration among older individuals is recommended to enhance their mental health, reduce the incidence of cognitive frailty, and foster active aging.
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Affiliation(s)
- Yamei Bai
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
| | - Yuqing Chen
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
| | - Meng Tian
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
| | - Jiaojiao Gao
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
| | - Yulei Song
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
| | - Xueqing Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
| | - Haiyan Yin
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
| | - Guihua Xu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, 210023, People’s Republic of China
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22
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Weng WH, Wang YH, Yeh NC, Yang YR, Wang RY. Effects of physical training on depression and related quality of life in pre-frail and frail older adults: a systematic review and meta-analysis. J Nutr Health Aging 2024; 28:100237. [PMID: 38643610 DOI: 10.1016/j.jnha.2024.100237] [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: 02/03/2024] [Revised: 03/11/2024] [Accepted: 04/12/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES To investigate the effects of physical training on depression and related quality of life in pre-frail and frail individuals. DESIGN A systematic review and meta-analysis. PARTICIPANTS Pre-frail and frail older adults. METHODS Five electronic databases, including PubMed, Cochrane, Medline, CINAHL, and Wiley were searched through December 2023. Randomized controlled trials (RCT) comparing physical training with usual care, health education, or light-intensity exercise were included. Outcomes included depression and depression-related quality of life. The quality of the included studies was assessed using Physiotherapy Evidence Database (PEDro) score, and the Cochrane Risk of Bias Tool was used to assess the risk of bias. Meta-analysis was performed using the RevMan5.4. The certainty of the evidence was evaluated by The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS Ten articles with 589 participants met the inclusion criteria and were included. The pooled analysis indicated that depression (SMD = -0.55, 95%CI = -0.92, -0.17, p = 0.004) and mental health status in life (SMD = 1.05, 95%CI = 0.59, 1.50, p < 0.00001) improved significantly in the experimental group. The results of subgroup analysis revealed that the beneficial effects of physical training were significant only in frail older adults but not in pre-frail older adults. CONCLUSION This meta-analysis showed that the positive effects of physical training on depression and related quality of life were evident for people with frailty. However, no positive results were observed in pre-frail older adults, indicating the need for further investigation in this subgroup.
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Affiliation(s)
- Wei-Han Weng
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yin-Hsiang Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Nai-Chen Yeh
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yea-Ru Yang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ray-Yau Wang
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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23
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Hou D, Sun Y, Liu Z, Sun H, Li Y, Wang R. A longitudinal study of factors associated with cognitive frailty in middle-aged and elderly population based on the health ecology model. J Affect Disord 2024; 352:410-418. [PMID: 38367710 DOI: 10.1016/j.jad.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 01/25/2024] [Accepted: 02/07/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Cognitive frailty (CF) is an important geriatric syndrome and is reversible. It is crucial to develop preventive interventions for CF. We aimed to explore the associations between CF and its associated factors in Chinese aged 45 years and above. METHODS Based on the available data of 3 waves in China Health and Retirement Longitudinal Study from 2011 to 2015, 16,071 individuals aged 45 years and above from 3 waves were included. Based on the health ecology model, the associated factors were classified as downstream, midstream and upstream factors. Generalized hierarchical linear model including time level, individual level, and province level was applied to analyze the associations between factors and CF. RESULTS Multilevel factors have different effects on physical and cognitive function. In the downstream, old age, female, underweight, chronic diseases, and depression were risk factors of reversible CF and potentially reversible CF, and overweight was their protective factor. In the midstream, short or long night sleep duration was their risk factor, and > 30 and ≤ 60 min afternoon naps, alcohol drinking, and participation in social activities were their protective factors. In the upstream, living in rural areas was their risk factor, and high educational level, household consumption and GDP per capita were their protective factors. CONCLUSIONS Physical function and cognitive function are affected differently by multiple factors. The occurrence and development of physical frailty and cognitive impairment may have some common mechanisms. CF can be influenced by multilevel factors, and multilevel and comprehensive management of CF should be achieved. KEY POINTS Cognitive frailty was correlated with multilevel factors, including downstream, midstream, and upstream factors. It is crucial to focus on individual interventions such as physiological factors, psychological factors and health behaviors, especially the elderly, women and those with depression. Socioeconomic status was associated with the lower prevalence of cognitive frailty.
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Affiliation(s)
- Dingchun Hou
- School of Nursing, Peking University, Beijing 100191, China
| | - Yumei Sun
- School of Nursing, Peking University, Beijing 100191, China
| | - Zhike Liu
- School of Public Health, Peking University, Beijing 100191, China
| | - Hongyu Sun
- School of Nursing, Peking University, Beijing 100191, China.
| | - Yi Li
- School of Public Health, Peking University, Beijing 100191, China.
| | - Rui Wang
- School of Nursing, Peking University, Beijing 100191, China
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24
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Biçak Ayik D, Cengiz Z, Isik K. The effect of frailty levels of older individuals on their mental well-being and depression levels. Psychogeriatrics 2024; 24:637-644. [PMID: 38467447 DOI: 10.1111/psyg.13110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Frailty has become an important public health issue. This study was conducted to determine the effect of frailty levels of older individuals on their mental well-being and depression levels. METHODS This descriptive cross-sectional study was conducted with a total of 325 older individuals aged 60 years and over. A demographic questionnaire form, the FRAIL Frailty Scale, the Warwick-Edinburgh Mental Well-Being Scale, and the Geriatric Depression Scale-Short Form were used to collect data. Data were evaluated using the SPSS 25.0 package program. Number, percentage, mean, standard deviation, Chi-square, correlation, and multiple regression analyses were used. RESULTS The mean age of the older individuals was 69.56 ± 7.75 years, and the variables of age, education level, income status, the person they were living with, regular medication use, forgetting to take medication, urinary incontinence, hospitalisation, and accidents were found to affect both frailty and depression (P < 0.05). There was a positive correlation between frailty and depression (r: 0.460, P < 0.001) and a negative correlation between mental frailty and well-being (r: -0.391, P < 0.001). Socio-demographic variables, depression, and mental well-being had a 40% effect on frailty (P < 0.001). CONCLUSION Depression status and mental well-being level are related to frailty, so negativity in one of them negatively affects the other. In line with these results, it is recommended to determine the level of depression and mental well-being of older individuals with high risk of frailty, and according to the results of the research, to provide care and support regarding the predictors affecting frailty.
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Affiliation(s)
- Derya Biçak Ayik
- Faculty of Health Sciences, Department of Internal Medicine Nursing, Mardin Artuklu University, Mardin, Turkey
| | - Zeliha Cengiz
- Faculty of Nursing, Department of Fundamentals Nursing, Inönü University, Malatya, Turkey
| | - Kevser Isik
- Faculty of Health Science, Department of Public Health Nursing, Gaziantep University, Gaziantep, Turkey
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25
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Yuan C, Zhang Y. Modifiable risk factors of cognitive frailty in community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Knowl 2024; 35:177-185. [PMID: 37378541 DOI: 10.1111/2047-3095.12437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To perform a meta-analysis identifying the modifiable risk factors of cognitive frailty in the elderly. METHODS We systematically searched databases including PubMed, EMBASE, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform from January 01, 2017 to March 26, 2022. Quantitative, original research reporting associated factors were included. FINDINGS 7,854 records in total were identified, of which 14 articles (1 prospective, 13 cross-sectional) with 36 factors were included. Studies on cognitive frailty included 20,390 community-dwellers (≥60 years) from three countries. Meta-analysis indicated that depression [OR = 3.60, 95%CI (2.25,5.78), p < 0.01] and sleep problems [OR = 2.36, 95%CI (1.62,3.43), p < 0.01] were associated with cognitive frailty. CONCLUSIONS Effective interventions targeting depression and sleep problems may lower the risk of cognitive frailty in the community seniors but need further study in high-quality, prospective studies. IMPLICATIONS FOR NURSING PRACTICE Building on previous work, the objectives of this systematic review and meta-analysis were to explore potential modifiable risk factors for cognitive frailty in community-dwelling older adults, which is expected to throw light on the prevention of cognitive frailty.
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Affiliation(s)
- Chen Yuan
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yixiong Zhang
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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26
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Yin H, Gao C, Quan Z, Zhang Y. The relationship between frailty, walking ability, and depression in elderly Chinese people. Medicine (Baltimore) 2023; 102:e35876. [PMID: 37960734 PMCID: PMC10637547 DOI: 10.1097/md.0000000000035876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/11/2023] [Indexed: 11/15/2023] Open
Abstract
To explore the relationship between depression symptoms, frailty, and walking ability in Chinese elderly people, and to provide new evidence for research on the prevention and treatment of depression in Chinese elderly people. The data of this study is sourced from the 2018 CHARLS data (China Health and Retirement Longitudinal Study). Z-test, logistic regression, and linear stratified regression were used to analyze the walking ability, frailty, and depressive symptoms of 2927 participants. Good walking ability and non frailty were significantly negatively correlated with depression symptoms in the elderly (P < .05). This important negative association persists even after adjusting for demographic, health condition, and lifestyle factors. (P < .05). Elderly women are at a higher risk of developing depression than men, while elderly people with good walking ability and no frailty are at a lower risk of developing depression. At the same time, elderly people with disabilities, hypertension, arthritis, and low levels of physical activity are more likely to experience depressive symptoms. It is recommended that elderly people pay attention to maintaining walking ability and avoiding frailty to reduce the risk of depression.
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Affiliation(s)
- Hang Yin
- School of Sports Medicine, Anshan Normal University, Anshan, China
| | - Caizhu Gao
- College of Physical Education, Kookmin University, Seoul, South Korea
| | - Zhengri Quan
- School of Physical Education, Changchun Normal University, Changchun, China
| | - Yaqun Zhang
- School of Sports Medicine, Anshan Normal University, Anshan, China
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27
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Qiu Y, Li G, Zheng L, Liu W, Li X, Wang X, Chen L. Relationship Between Cognitive Frailty and Mortality in Older Adults: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2023; 24:1637-1644.e8. [PMID: 37660724 DOI: 10.1016/j.jamda.2023.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023]
Abstract
OBJECTIVE To synthesize the pooled mortality risk estimate and determine whether cognitive frailty is a predictor of mortality. DESIGN A systematic review and meta-analysis. SETTING AND PARTICIPANTS The participants were community-dwelling older adults aged ≥60 years. METHODS PubMed, Web of Science, Embase, CINAHL, and the Cochrane Library databases were systematically searched. Two researchers independently screened potentially eligible literature, evaluated the quality of the included studies, and then extracted the data. We used STATA, version 15.0 to perform the all data. RESULTS Nineteen studies were included. The association between cognitive frailty and a higher risk of death was statistically significant [hazard ratio (HR), 2.01; 95% CI, 1.84-2.19; P < .001]. The outcomes indicated that cognitive frailty was a critical risk factor for predicting mortality (OR, 4.82; 95% CI, 1.59-14.57; P < .01). Based on different models of cognitive frailty, the results of subgroup analyses revealed that the risk of mortality was the highest in the Frail + mild cognitive impairment group (HR, 2.35; 95% CI, 2.05-2.70; P < .001). The subgroup analyses by region demonstrated that mortality risk was lowest in the European group (HR, 1.63; 95% CI, 1.4-1.87; P < .001). CONCLUSIONS AND IMPLICATIONS This study quantitatively portrays the pooled mortality risk estimate of cognitive frailty. The results suggest that in older adults, cognitive frailty can be a predictor of mortality. The findings could alert health care providers to pay more attention to cognitive frailty.
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Affiliation(s)
- Yiming Qiu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Guichen Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Lufang Zheng
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Wei Liu
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xin Li
- School of Nursing, Jilin University, Changchun, Jilin, China
| | - Xinxin Wang
- The First Hospital of Jilin University, Changchun, Jilin, China.
| | - Li Chen
- School of Nursing, Jilin University, Changchun, Jilin, China; Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, Jilin, China.
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28
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Pietrzak B, Kujawa J, Lipert A. Depressive Disorders, Cognitive and Physical Function of Older People in Early Dementia Detection. Life (Basel) 2023; 13:2010. [PMID: 37895392 PMCID: PMC10608476 DOI: 10.3390/life13102010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Aging is associated with cognitive decline, leading to cognitive and physical impairments, which are risk factors for loss of independence and dementia development. Early diagnosis is beneficial for both, the patient and their family, to avoid long-term consequences. The aim of this study was to analyze the frequency of depressive disorders and their influence on cognitive and physical function of older people in early dementia detection. METHODS There were 852 patients, aged at least 60 years, from the Central Teaching Hospital. The study was conducted between September 2022 and June 2023. The qualified participants were examined using four tools: Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), Timed Up and Go (TUG) and Schulman's Clock-Drawing Test. RESULTS Over one-third had depressive disorders. A relationship with p < 0.05 was observed between GDS and IADL: r = -0.61. A relationship with p > 0.05 was observed between GDS and TUG: r = -024. A relationship with p < 0.05 was observed between GDS and CDT: r = 0.74. CONCLUSIONS The first signs of depressive disorders in older people may be considered an indication for further diagnosis of dementia.
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Affiliation(s)
- Beata Pietrzak
- Department of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (B.P.); (J.K.)
| | - Jolanta Kujawa
- Department of Medical Rehabilitation, Medical University of Lodz, 92-213 Lodz, Poland; (B.P.); (J.K.)
| | - Anna Lipert
- Department of Sports Medicine, Medical University of Lodz, 92-213 Lodz, Poland
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29
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Corral-Pérez J, Casals C, Ávila-Cabeza-de-Vaca L, González-Mariscal A, Martínez-Zaragoza I, Villa-Estrada F, Reina-Campos R, Vázquez-Sánchez MÁ. Health factors associated with cognitive frailty in older adults living in the community. Front Aging Neurosci 2023; 15:1232460. [PMID: 37790284 PMCID: PMC10544977 DOI: 10.3389/fnagi.2023.1232460] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
Introduction This study aims to investigate the health factors associated with cognitive frailty in frail and pre-frail older adults living in the community. Methods A total of 233 older adults meeting Fried's criteria for pre-frailty or frailty were included. Cognitive status was evaluated using the Short Portable Mental Status Questionnaire. Health factors encompassed nutritional status (evaluated using the Mini Nutritional Assessment tool, body mass index, and waist, arm, and leg circumferences), physical function (assessed with the Short Physical Performance Battery), quality of life (measured with the total index of the EuroQoL 5-Dimension 5-Level questionnaire - EQoL-Index -, and the Visual-Analogue Scale - QoL-VAS - for today's health state), as well as sleep, physical activity, and inactivity estimated through wrist-worn accelerometers. Multivariable logistic regression analyses were conducted to identify potential predictors of cognitive frailty, considering age as a confounding factor. Results Cognitive frail participants exhibited advanced age, heightened self-reported exhaustion, diminished overall physical performance, reduced leg perimeter, decreased engagement in moderate-to-vigorous physical activity, and higher levels of inactivity (all p<0.05). However, after adjusting for age, only QoL-VAS emerged as a cognitive frailty risk factor (Odds ratio: 1.024), while the EQoL-Index, calf perimeter, and levels of moderate-to-vigorous physical activity were identified as protective factors (Odds ratios: 0.025, 0.929, and 0.973, respectively). Discussion This study highlights the complex relationship between non-modifiable factors such as age, and modifiable factors including quality of life, nutritional status, and physical activity in the development of cognitive frailty among older adults with a frailty phenotype living in the community.
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Affiliation(s)
- Juan Corral-Pérez
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Cristina Casals
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Laura Ávila-Cabeza-de-Vaca
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | - Andrea González-Mariscal
- ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain
| | | | | | | | - María Á. Vázquez-Sánchez
- Department of Nursing, Faculty of Health Sciences, University of Malaga, Málaga, Spain
- PASOS Research Group, UMA REDIAS Network of Law and Artificial Intelligence Applied to Health and Biotechnology, University of Malaga, Málaga, Spain
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Monteiro AM, Borges MK. Association of frailty with cognitive impairment and functional disability in older adults with affective disorders: a brief research report. Front Psychiatry 2023; 14:1181997. [PMID: 37496684 PMCID: PMC10366589 DOI: 10.3389/fpsyt.2023.1181997] [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] [Received: 03/08/2023] [Accepted: 06/20/2023] [Indexed: 07/28/2023] Open
Abstract
Introduction The Clinical-Functional Vulnerability Index (IVCF-20) is a validated multidimensional instrument that has been used in Brazil to evaluate functional disability in frail older adults. The main aim of this study was to assess frailty using this novel screening tool. In addition, to investigate whether frailty was associated with cognitive impairment and functional disability in older adults with affective disorders. Methods Participants included were over 60 years old, with affective disorders (depressive or anxiety disorders), from two specialized outpatient clinics. The sample was comprised of 46 patients (30% of a total from 153). The following instruments were applied: Clock Drawing Test (CDT), Mini Mental State Examination (MMSE); Verbal Fluency Test (VFT); Pfeffer Questionnaire or Functional Assessment Questionnaire (FAQ); Katz Index; Geriatric Depression Scale (GDS-15); Geriatric Anxiety Inventory (GAI), and IVCF-20 as well as sociodemographic and clinical questionnaires. The association between the variables of interest was estimated using Spearman correlation. Results This study found a negative correlation between frailty and cognitive decline (MMSE; rs = -0.58; p < 0.001); (VFT; rs = -0.60; p < 0.001); (CDT; rs = -0.47; p = 0.001) and a positive correlation between frailty and depressive symptoms (GDS-15; rs = 0.34; p = 0.019) as well as disability for IADLs (FAQ; rs = 0.69; p < 0.001). However, there was no statistical difference in the association between frailty and anxiety symptoms (GAI; rs = 0.24; p = 0.103) or disability for BADLs (Katz; rs = -0.02; p = 0.895). Discussion Our data support that the associations between frailty, cognitive and functional disability are prevalent issues in Psychogeriatrics. Assessing frailty in a multidimensional context is essential using a rapid assessment frailty tool in clinical practice.
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Affiliation(s)
- Ariane M. Monteiro
- Department of Internal Medicine, Post-Graduate Program of Internal Medicine and Health Sciences (PPGMICS), Complexo do Hospital de Clínicas, Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
| | - Marcus K. Borges
- Department of Internal Medicine and Psychiatry (Geriatric Psychiatry), Post-Graduate Program of Internal Medicine and Health Sciences (PPGMICS), Complexo do Hospital de Clínicas, Universidade Federal do Paraná (CHC-UFPR), Curitiba, Brazil
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Panza F, Solfrizzi V, Sardone R, Dibello V, Castellana F, Zupo R, Stallone R, Lampignano L, Bortone I, Mollica A, Berardino G, Ruan Q, Altamura M, Bellomo A, Daniele A, Lozupone M. Depressive and Biopsychosocial Frailty Phenotypes: Impact on Late-life Cognitive Disorders. J Alzheimers Dis 2023:JAD230312. [PMID: 37355907 DOI: 10.3233/jad-230312] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
In older age, frailty is a detrimental transitional status of the aging process featuring an increased susceptibility to stressors defined by a clinical reduction of homoeostatic reserves. Multidimensional frailty phenotypes have been associated with all-cause dementia, mild cognitive impairment (MCI), Alzheimer's disease (AD), AD neuropathology, vascular dementia, and non-AD dementias. In the present article, we reviewed current evidence on the existing links among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders, also examining common pathways and mechanisms underlying these links. The depressive frailty phenotype suggested by the construct of late-life depression (LLD) plus physical frailty is poorly operationalized. The biopsychosocial frailty phenotype, with its coexistent biological/physical and psychosocial dimensions, defines a biological aging status and includes motivational, emotional, and socioeconomic domains. Shared biological pathways/substrates among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders are hypothesized to be inflammatory and cardiometabolic processes, together with multimorbidity, loneliness, mitochondrial dysfunction, dopaminergic neurotransmission, specific personality traits, lack of subjective/objective social support, and neuroendocrine dysregulation. The cognitive frailty phenotype, combining frailty and cognitive impairment, may be a risk factor for LLD and vice versa, and a construct of depressive frailty linking physical frailty and LLD may be a good dementia predictor. Frailty assessment may enable clinicians to better target the pharmacological and psychological treatment of LLD. Given the epidemiological links of biopsychosocial frailty with dementia and MCI, multidomain interventions might contribute to delay the onset of late-life cognitive disorders and other adverse health-related outcomes, such as institutionalization, more frequent hospitalization, disability, and mortality.
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Affiliation(s)
- Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Vittorio Dibello
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Qingwei Ruan
- Laboratory of Aging, Anti-aging & Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Shanghai Medical 14 College, Fudan University, Shanghai, China
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
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Niegowska W, Szydlik J, Barszczewska M, Grodzka O, Czapski P, Januszewska K, Sawicka A, Jankowski P, Kupisz-Urbańska M. ANALYSIS OF FACTORS ASSOCIATED WITH FRAILTY SYNDROME IN PATIENTS WITH HEART FAILURE. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2023; 51:216-220. [PMID: 37589105 DOI: 10.36740/merkur202303105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
OBJECTIVE Aim: Determination of factors associated with frailty syndrome (FS) in patients with heart failure (HF). PATIENTS AND METHODS Materials and methods: Consecutive patients hospitalized in the department were assessed for the presence of FS using L. Fried criteria, Edmonton Frail Scale (EFS) and Tilburg Frailty Indicator (TFI). Presence of arterial hypertension, diabetes, obesity, chronic obstructive pulmonary disease (COPD), and heart failure was included in the analysis based on patients' medical history and findings from current hospitalization. Patients were assessed for the presence of depression using Beck's Depression Inventory (BDI). Physical capacity was assessed using NYHA classification. RESULTS Results: 87 patients (mean age 81.4±6.7; 57 women; 11 HFrEF, mean NYHA 2.36±1.21; 11 HFmrEF, mean NYHA 2.18±1.08; 65 HFpEF mean NYHA 1.94±1.09) were included in the analysis. Multivariable analysis showed significant relationship between FS assessed with EFS and age (β=0.316, SE=0.08; p=0.0001), arterial hypertension (β=-0.194, SE=0.08; p=0.0173), COPD (β=0.176, SE=0.08; p=0.0300) and depression (β=0.565, SE=0.08; p=0.0000). FS assessed with L. Fried criteria was significantly related to age (β=0.359, SE=0.09; p= 0.0001), NYHA classification (β= 0.336, SE=0.09; p=0.0002) and depression (β=0.297, SE=0.09; p=0.0010). Age (β=0.251, SE=0.10; p=0.0114) and depression (β=0.375, SE=0.1; p=0.0002) were significantly related to FS assessed using TFI. In multivariable analysis HF phenotype was not significantly related to FS. CONCLUSION Conclusions: Age and depression assessed with BDI are related to FS in patients with HF. Arterial hypertension and COPD are linked to FS assessed using EFS, whereas NYHA classification is linked to FS assessed with L. Fried criteria. No statistically significant relationship was found between FS and HF phenotype.
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Affiliation(s)
- Wiktoria Niegowska
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
| | - Julia Szydlik
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
| | - Marcelina Barszczewska
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
| | - Olga Grodzka
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
| | - Piotr Czapski
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
| | - Katarzyna Januszewska
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
| | - Ada Sawicka
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
| | - Piotr Jankowski
- DEPARTMENT OF INTERNAL MEDICINE AND GERIATRIC CARDIOLOGY, CENTRE OF POSTGRADUATE MEDICAL EDUCATION, WARSAW, POLAND
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