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

Brígola, Allan Gustavo; Luchesi, Bruna Moretti; Alexandre, Tiago da Silva; Inouye, Keika; Mioshi, Eneida; Pavarini, Sofía Cristina Iost

doi:10.1590/2237-6089-2016-0085

Cited by 21 publications

(28 citation statements)

References 27 publications

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“…The study was conducted between April and December of 2014. The participant selection process is described elsewhere 3,17,18 , but a brief description follows. All communitydwelling older adults (age≥60 in Brazil, as defined by the World Health Organization) registered at 18 primary healthcare centers (n=1,188) in São Carlos City, Brazil, were contacted in person and invited to participate in the survey.…”

Section: Participantsmentioning

confidence: 99%

“…Cognitive impairment can be caused by neurodegeneration, vascular problems and metabolic problems. Nonetheless, chronic stress, depressive symptoms and anxiety can contribute to a poorer mental performance during old age 3 . Lately, the poor physical function, such as frailty, is considered another strong factor linked to cognitive impairment, seen that these conditions share similar pathophysiological mechanisms on the cellular and systemic levels 4,5 .…”

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confidence: 99%

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Association between cognitive impairment and criteria for frailty syndrome among older adults

Brígola

Ottaviani

Carvalho

et al. 2020

Arq. Neuro-Psiquiatr.

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The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. Objective: To analyze the association between cognitive impairment and the criteria for frailty. Methods: We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled ‘Variables associated to cognition in elderly caregivers’ involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. Results: Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. Conclusion: Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty.

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Section: Participantsmentioning

confidence: 99%

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confidence: 99%

Association between cognitive impairment and criteria for frailty syndrome among older adults

Brígola

Ottaviani

Carvalho

et al. 2020

Arq. Neuro-Psiquiatr.

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“…Current understandings of frailty and cognition suggest that their relationship is bidirectional. For instance, longitudinal studies among the general population of older adults suggest that frailty status predicts cognitive decline (Godin et al, 2017, Auyeung et al, 2011, Mitnitski et al, 2011, Lee et al, 2018, Brigola et al, 2017 and incident dementia (Boyle et al, 2010a, Gray et al, 2013, Buchman et al, 2007 and also that cognitive decline is predictive of the development of frailty syndrome (Raji et al, 2010, Gale et al, 2017. A large body of research suggests several multi-system, physiologic processes underlie the pathogenesis of frailty syndrome and may explain its contribution to cognitive impairment.…”

Section: Introductionmentioning

confidence: 99%

Pre-frailty predicts cognitive decline at 2-year follow-up in persons living with HIV

et al. 2019

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Both HIV disease and frailty syndrome are risk factors for neurocognitive impairment. Longitudinal research among individuals of the general population suggests that frailty predicts future cognitive decline; however, there is limited evidence for these longitudinal relationships among people living with HIV (PLWH). The current study evaluated and compared rates of cognitive decline over 2 years among HIV serostatus and frailty status groups. Participants included 50 PLWH and 60 HIV-uninfected (HIV−) participants who were evaluated at baseline and 2-year follow-up visits. Baseline frailty status (non-frail, pre-frail, and frail) was determined using fried frailty phenotype criteria. Neurocognitive functioning was measured using practice-effect corrected scaled scores derived from a comprehensive neuropsychological battery covering seven cognitive domains. Repeated measures analysis was used to estimate rates of global and domain-specific cognitive change from baseline to 2-year follow-up among each of six HIV/frailty status groups. Among PLWH, the pre-frail group demonstrated consistent declines in global cognitive functioning (B = − 0.029, p = 0.034), processing speed (B = − 0.047, p = 0.031), and motor functioning (B = − 0.048, p = 0.038). Among HIV− participants, pre-frail individuals also declined in global cognitive functioning and processing speed (ps ≤ 0.05). HIV− non-frail participants also declined in the cognitive domains of learning, delayed recall, and motor functioning; however, these declines appeared to be driven by relatively higher baseline scores among this group. Notably, 38% of PLWH changed in frailty status from baseline to follow-up, and those with stable pre-frailty demonstrated higher likelihood for cognitive decline; change in depressive symptoms did not relate to change in frailty status. Current findings highlight pre-frailty as an important clinical syndrome that may be predictive of cognitive decline among PLWH. Interventions to prevent or reduce frailty among vulnerable PLWH are needed to maintain optimal cognitive health.

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“…Limited formal education can also be a predictor of frailty in older adults in Brazil. 14 , 15 Frailty is a dynamic and multidimensional syndrome, that affects human functioning and is caused by a range of variables that increase the risk for dependency, institutionalization and death in old age. 16 , 17 Older adults with low education in Europe also seem to have a three times higher risk of being categorized as frail, as opposed to older adults with higher levels of education.…”

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confidence: 99%

Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults

Brígola

Alexandre

Inouye

et al. 2019

Dement. neuropsychol.

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ABSTRACT. Limited formal education is still common in ageing populations. Although limited formal education seems to be independently and negatively associated with cognition, functional abilities and frailty in ageing, no studies have examined whether the gradient of limited formal education has an impact on health in later life. Objective: to examine the relationship of limited formal education with cognitive status, functional abilities, and frailty status. Methods: a cross-sectional study was conducted involving 540 older adults stratified into groups: no formal education, 12-24 months of education, and 25-48 months of education. Cognitive screening (MMSE), functional abilities (Lawton Index), and frailty (CHS criteria) were measured. Regression analyses were performed. Results: 27% had no formal education, 21% had 12-24 months of formal education, and 55% had 25-48 months of formal education. Limited formal education has a clear gradient of negative impact: No formal education was associated with scoring below MMSE cut-off scores (OR = 7.9), being totally/partially dependent for IADLs (OR = 2.5) and frail (OR = 2.0). Having 12-24 months of education was associated with scoring below MMSE cut-off scores (OR = 5.2) and with being frail (OR = 2.0). The No formal education group was 10.1 times more likely to have worse cognitive scores, worse functional abilities and frailty/pre-frailty status concomitantly (CCoFF), while older adults who had 12-24 months of education had a 4.6 times greater chance of having CCoFF. Conclusion: limited education had a gradient association with cognitive performance, functional disability and frailty. These findings clearly emphasize the importance of prevention through education from childhood to older age.

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

Cited by 21 publications

References 27 publications

Association between cognitive impairment and criteria for frailty syndrome among older adults

Association between cognitive impairment and criteria for frailty syndrome among older adults

Pre-frailty predicts cognitive decline at 2-year follow-up in persons living with HIV

Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults

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