Relationship between cognition and frailty in elderly: A systematic review

Brígola, Allan Gustavo; Rossetti, Estefani Serafim; Santos, Bruna Rodrigues dos; Néri, Anita Liberalesso; Zazzetta, Marisa Silvana; Inouye, Keika; Pavarini, Sofía Cristina Iost

doi:10.1590/1980-57642015dn92000005

Cited by 93 publications

(67 citation statements)

References 41 publications

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“…to 25%, and frailty reached 10%, regardless of the way how it is described. 25 The phenomenon observed in the present study reflects a complex relationship between cognitive functioning and frailty in elderly people. This association has been increasingly studied, and promising results in the area are expected.…”

Section: Discussionmentioning

confidence: 51%

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

Brígola

Luchesi

Alexandre

et al. 2017

Trends Psychiatry Psychother.

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.4% e pré-fragilidade de 52.9% nos idosos cuidadores. Cuidadores severamente sobrecarregados ou frágeis apresentaram pior desempenho cognitivo comparado àqueles levemente sobrecarregados e não frágeis, respectivamente (teste ANOVA). Apresentar simultaneamente sobrecarga elevada e algum grau de fragilidade (pré-frágil ou frágil) esteve associado à redução do desempenho cognitivo global. Conclusão: Um significante número de idosos cuidadores teve indício de alteração cognitiva. Estratégias e recursos para reduzir o sentimento de sobrecarga e a fragilidade física podem melhorar o desempenho mental e o bem estar, levando assim a uma melhora da qualidade de vida do idoso que cuida, bem como a qualidade do cuidado prestado por ele. Descritores: Cuidado a idosos, cuidadores, idoso frágil, cognição, população rural. AbstractIntroduction: Older caregivers living in rural areas may be exposed to three vulnerable conditions, i.e., those related to care, their own aging, and their residence context. Objective: To analyze the association of burden and frailty with cognition performance in older caregivers in rural communities. Method: In this cross-sectional survey, 85 older caregivers who cared for dependent elders were included in this study. Global cognition (Addenbrooke's Cognitive Examination -Revised; Mini Mental State Examination), burden (Zarit Burden Interview) and frailty (Fried's frailty phenotype) were assessed. All ethical principles were observed. Results: Older caregivers were mostly women (76.7%); mean age was 69 years. Cognitive impairment was present in 15.3%, severe burden in 8.2%, frailty in 9.4%, and pre-frailty in 52.9% of the older caregivers. More severely burdened or frail caregivers had worse cognitive performance than those who were not, respectively (ANOVA test). Caregivers presenting a high burden level and some frailty degree (pre-frail or frail) simultaneously were more likely to have a reduced global cognition performance. Conclusion: A significant number of older caregivers had low cognitive performance. Actions and resources to decrease burden and physical frailty may provide better cognition and well-being, leading to an improved quality of life and quality of the care provided by the caregivers. Keywords: Aged care, caregivers, frail elderly, cognition, rural population. Cognition, burden and frailty in rural caregivers -Brigola et al.

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Section: Discussionmentioning

confidence: 51%

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

Brígola

Luchesi

Alexandre

et al. 2017

Trends Psychiatry Psychother.

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“…Only two studies in this review adjusted for mini‐mental state examination scores (MMSE) and for number of medications . Evidence derived from systematic reviews indicates that cognitive function is associated with frailty . To enhance the process of comparing the findings between future studies assessing the association between oral health and frailty, standardization of covariates should be considered.…”

Section: Discussionmentioning

confidence: 99%

Association between oral health and frailty: A systematic review of longitudinal studies

2019

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Objective To systematically review longitudinal studies on the association between oral health and frailty indicated by any validated scale or index. Background Frailty and poor oral health are common among ageing populations; however, evidence from longitudinal studies is scarce. Methods Three databases (MEDLINE, EMBASE and LILACS) were searched for published literature up to July 2018 using prespecified search strategy. Grey literature was searched using OpenGrey and Google Scholar. Quality of included studies was checked using the Newcastle‐Ottawa Quality Assessment Scale (NOS) for longitudinal studies. Results Five longitudinal studies from three countries (Mexico, Japan, and UK) that examined the association between oral health and frailty were identified. All studies used Fried's frailty phenotype criteria for measuring frailty. Oral health indicators were number of teeth, periodontal disease, oral functions (functional dentition with occluding pairs and maximum bite force), use of removable dentures, accumulation of oral health problems and dry mouth symptoms. The studies showed significant association of number of teeth (two studies), oral functions (two studies), accumulation of oral health problems and number of dry mouth symptoms with frailty incidence, whereas periodontal disease showed inconsistent associations. Conclusion This systematic review identified significant longitudinal associations between oral health indicators and frailty that highlight the importance of oral health as a predictor of frailty in older age. There is a need for further research exploring the role of nutrition as a mediator of the relationship between oral health and frailty.

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“…As a tool that measures global cognitive function, it may be less sensitive to cognitive changes and unable to pinpoint domain-specific effects compared with comprehensive neuropsychologic batteries; however, it is an appealing instrument for a variety of evaluation settings where speed and ease of repeated assessments are needed. Although studies among adults with ESRD 35 and older adults 23,59 have shown positive findings for specific cognitive domains, with the strongest associations for executive function 23,35,59,60 -a critical domain that deteriorates with onset of vascular dementia 61 -additional research is needed to assess the association with specific cognitive domain for a better understanding of underlying mechanisms among KT recipients. Additionally, clinical complications post-transplant not captured in this study, such as infection, acute rejection, and metabolic derangements, may also influence cognitive function post-KT and should be investigated in subsequent analyses.…”

Section: Discussionmentioning

confidence: 99%

Frailty and Changes in Cognitive Function after Kidney Transplantation

Chu¹,

Gross²,

Shaffer³

et al. 2019

JASN

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Background Restoration of kidney function after kidney transplant generally improves cognitive function. It is unclear whether frail recipients, with higher susceptibility to surgical stressors, achieve such posttransplant cognitive improvements or whether they experience subsequent cognitive decline as they age with a functioning graft.Methods In this two-center cohort study, we assessed pretransplant frailty (Fried physical frailty phenotype) and cognitive function (Modified Mini-Mental State Examination) in adult kidney transplant recipients. To investigate potential short-and medium-term effects of frailty on post-transplant cognitive trajectories, we measured cognitive function up to 4 years post-transplant. Using an adjusted mixed effects model with a random slope (time) and intercept (person), we characterized post-transplant cognitive trajectories by pretransplant frailty, accounting for nonlinear trajectories. ResultsOf 665 recipients (mean age 52.0 years) followed for a median of 1.5 years, 15.0% were frail. After adjustment, pretransplant cognitive scores were significantly lower among frail patients compared with nonfrail patients (89.0 versus 90.8 points). By 3 months post-transplant, cognitive performance improved for both frail (slope =0.22 points per week) and nonfrail (slope =0.14 points per week) recipients. Between 1 and 4 years post-transplant, improvements plateaued among nonfrail recipients (slope =0.005 points per week), whereas cognitive function declined among frail recipients (slope =20.04 points per week). At 4 years post-transplant, cognitive scores were 5.8 points lower for frail recipients compared with nonfrail recipients.Conclusions On average, both frail and nonfrail recipients experience short-term cognitive improvement post-transplant. However, frailty is associated with medium-term cognitive decline post-transplant. Interventions to prevent cognitive decline among frail recipients should be identified.

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Relationship between cognition and frailty in elderly: A systematic review

Cited by 93 publications

References 41 publications

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

High burden and frailty: association with poor cognitive performance in older caregivers living in rural areas

Association between oral health and frailty: A systematic review of longitudinal studies

Frailty and Changes in Cognitive Function after Kidney Transplantation

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