Co-occurrence of cognitive impairment and physical frailty, and incidence of dementia: Systematic review and meta-analysis

Grande, Giulia; Haaksma, Miriam L.; Rizzuto, Debora; Melis, René J. F.; Marengoni, Alessandra; Onder, Graziano; Welmer, Anna‐Karin; Fratiglioni, Laura; Vetrano, Davide Liborio

doi:10.1016/j.neubiorev.2019.09.001

Cited by 78 publications

(68 citation statements)

References 41 publications

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“…They also suggest that intervening to prevent or reduce frailty may decrease incident cognitive impairment and dementia even in those carrying an APOE ε4 allele, a proposition that requires further testing. These findings complement and extend the results of a recent systematic review and meta-analysis that identified the common co-occurrence of physical frailty and cognitive impairment among those individuals most likely to develop dementia, 23 and support findings from the UK Biobank whereby dementia risk may be modified by general health factors (ie, lifestyle) at any level of genetic risk. 8 Although older age is often considered to be characterised by functional decline, we observed that functional improvement was common in our sample.…”

Section: Discussionsupporting

confidence: 85%

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

Ward

Wallace

Rockwood

2020

J Neurol Neurosurg Psychiatry

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ObjectiveTo determine whether health-deficit accumulation is associated with the risks of mild cognitive impairment (MCI) and dementia independently of APOE genotype.MethodsA frailty index was calculated using the deficit-accumulation approach in participants aged 50 years and older from the National Alzheimer’s Coordinating Center. Cognitive status was determined by clinical evaluation. Using multistate transition models, we assessed the extent to which an increasing degree of frailty affected the probabilities of transitioning between not cognitively impaired (NCI), MCI, and dementia.ResultsParticipants (n=14 490) had a mean age of 72.2 years (SD=8.9 years; range=50–103 years). Among those NCI at baseline (n=9773), each 0.1 increment increase in the frailty index was associated with a higher risk of developing MCI and a higher risk of progressing to dementia. Among those with MCI at baseline (n=4717), higher frailty was associated with a higher risk of progressing to dementia, a lower probability of being reclassified as NCI, and a higher likelihood of returning to MCI in those that were reclassified as NCI. These risk effects were present and similar in both carriers and non-carriers of the APOE ε4 allele.ConclusionAmong older Americans, health-deficit accumulation affects the likelihood of progressive cognitive impairment and the likelihood of cognitive improvement independently of a strong genetic risk factor for dementia. Frailty represents an important risk factor for cognitive dysfunction and a marker of potential prognostic value.

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Section: Discussionsupporting

confidence: 85%

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

Ward

Wallace

Rockwood

2020

J Neurol Neurosurg Psychiatry

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“…Physical frailty can predict the occurrence of cognitive impairment or mild cognitive impairment (MCI). A recent meta-analysis found that the co-occurrence of physical frailty and cognitive impairment was associated with a higher hazard ratio of incident dementia than each condition separately 8 . Therefore, early identification of this syndrome could lead to the secondary prevention of dementia and disability 9,10 .…”

Section: Jfsf 63mentioning

confidence: 99%

The prevalence of cognitive frailty and pre-frailty among older people in Bangkok metropolitan area: a multicenter study of hospital-based outpatient clinics

Wongtrakulruang

Muangpaisan

Panpradup

et al. 2020

JFSF

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Objectives: To identify the prevalence of, and factors associated with, cognitive frailty and prefrailty, and to investigate correlation between frailty tools. Methods: One hundred and ninety five older adults were recruited from the medical outpatient clinics of 3 tertiary hospitals in Bangkok metropolitan region. The data collected were demographic information, lifestyle factors, functional status, mood assessment, and cognitive and frailty assessments. The frailty tools used were Frailty Phenotype and FRAIL scale. Results: The prevalence of pre-frailty, frailty, mild cognitive impairment (MCI), cognitive pre-frailty and cognitive frailty was 57.4%, 15.9%, 26.2%, 14.4% and 6.7%, respectively. A multivariate analysis showed that age ≥70 years (OR 5.34; 95% CI 2.06-12.63), and education at primary school or under (OR 4.18; 95% CI 1.61-10.82) were associated with cognitive frailty and cognitive pre-frailty. The correlation between physical frailty rated by the Modified Fried Frailty Phenotype and the FRAIL scale was good (Kappa coefficient = 0.741). Conclusions: The prevalence of cognitive frailty is not uncommon which requires screening and interventions. Age and a low educational level were related to cognitive frailty/prefrailty. The FRAIL scale yielded a high correlation with Frailty phenotypes, implying its benefit in routine clinical use in primary care practice, where there is limited time and resources.

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“…CF has been consistently shown to increase the risk of the progression toward dementia among older adults [4,7]. It was highlighted in the Singapore Longitudinal Ageing Studies (SLAS) that the risk of neurocognitive disorders increased three times among older adults with the co-existence of physical frailty and cognitive impairment, as compared to those with a single syndrome [8].…”

Section: Introductionmentioning

confidence: 99%

Incidence and Predictors of Cognitive Frailty Among Older Adults: A Community-based Longitudinal Study

Rivan

Shahar

Rajab

et al. 2020

IJERPH

104

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1) Background: Cognitive frailty (CF) is the simultaneous presence of physical frailty and cognitive impairment with an increased risk of dementia. Considering that the risk factors of CF are mostly elucidated from cross-sectional studies, we conducted a community-based longitudinal study to determine the incidence and the predictors of CF among Malaysian older adults.; (2) Methods: Out of 490 older adults participating in the Malaysian Towards Useful Aging (TUA) study, 282 were successfully followed-up at five-years for an analysis of the CF incidence. CF was defined as a comorbid physical frailty (>1 Fried criteria) and mild cognitive impairment (Petersen criteria). A comprehensive interview-based questionnaire was administered for sociodemographic information, cognitive function, physical function, dietary intake, psychosocial, and biochemical indices. Univariate analyses were performed for each variable, followed by a regression analysis to identify the predictors of CF that accounted for confounding effects between the studied factors; (3) Results: The incidence Int.rate of CF was 7.1 per 100 person-years. Advancing age (OR=1.12, 95% CI:1.04-1.21, p < 0.05), depression (OR=1.20, 95% CI:1.05-1.37, p < 0.05), decreased processing speed, assessed by a lower digit symbol score (OR=0.67, 95%CI:0.0.56-0.80, p < 0.05), decreased functional mobility measured using Timed-Up-and-Go (TUG) (OR=1.23, 95% CI:1.04-1.46, p < 0.05), low vitamin D intake (OR:0.36, 95% CI:0.14-0.93, p < 0.05) and physical frailty (OR=2.16, 95% CI:1.02-4.58, p < 0.05) were predictors for CF incidence; and (4) Conclusions: Our study results could be used as an initial reference for future studies to formulate effective preventive management and intervention strategies to decelerate CF development among older adults.

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Co-occurrence of cognitive impairment and physical frailty, and incidence of dementia: Systematic review and meta-analysis

Cited by 78 publications

References 41 publications

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

The prevalence of cognitive frailty and pre-frailty among older people in Bangkok metropolitan area: a multicenter study of hospital-based outpatient clinics

Incidence and Predictors of Cognitive Frailty Among Older Adults: A Community-based Longitudinal Study

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