Cognitive Frailty Among Elderly Chinese Patients With Cerebral Small Vessel Disease: A Structural MRI Study

Abstract

Cognitive frailty (CF) is gaining an increasing amount of attention in geriatric research. CF refers to the co-occurrence of physical frailty and cognitive impairment in people without dementia. Neuroimaging of elderly people has revealed the presence of numerous white matter lesions, which is a typical biomarker of cerebral small vessel disease (SVD) on magnetic resonance images. The aim of the present study was to estimate the prevalence of CF in elderly Chinese patients with SVD. One hundred and thirty elderly patients with SVD were recruited for this cross-sectional observational study. Participants who met three to five of the Fried criteria of the physical frailty (PF) phenotype (shrinking, weakness, slowness, self-reported exhaustion, or low physical activity) were classified as having PF. Then, individuals with PF were defined as having CF if mild cognitive impairment was discovered by the Mini-Mental State Examination. Lastly, a series of cognitive function tests and the dual-task walking paradigm were examined. Based on the CF diagnostic criteria, the frequency of CF was 23.08% among elderly Chinese patients with SVD. Furthermore, CF-positive patients had a more significant SVD burden, based on magnetic resonance imaging findings. Logistic regression analysis, which was adjusted for age, sex, education, and comorbidities, showed that CF was negatively correlated with the dual-task walking speed in elderly people with SVD. Thus, SVD burden might be an indicator of CF phenotype. In elderly patients with SVD, CF was associated with dual task walking performance.

Prevalence and Risk Factors for Cognitive Frailty in Aging Hypertensive Patients in China

“…This may be due to the use of different assessment tools and geographical differences. A cross-sectional survey conducted in China [37] found that the prevalence rate of CF was 23.08%. The higher rate in that study may be because the aging individuals were not recruited from the community but from among patients with cerebrovascular disease in the Department of Neurology.…”

An update on cognitive frailty: Its definition, impact, associated factors and underlying mechanisms, and interventions

“…Sugimoto et al 59 demonstrated that those with cognitive frailty had greater white matter hyperintensities than those without in the memory clinic population. Zhào et al 21 also reported that cognitively frail subjects had greater white matter hyperintensities assessed by the Fazekas scaler than those without cognitive frailty, while the difference was not statistically significant in their multivariate analysis. Wan et al 60 investigated the brain structural characteristics in the subcortical nuclei between older adults with cognitive frailty and matched healthy older adults by using diffusion tensor imaging and found significant microstructural atrophy in the subcortical nuclei, including the bilateral thalami, left caudate, right pallidum and accumbens area in cognitive frail subjects.…”

“…4 However, the association of cognitive frailty with lower physical performance including a slower timed up and go test, weaker grip strength, slower dual task walking speed, as well as disability in activities of daily living were reported in several studies. 21,23,25,36,37,41 For example, cognitive frailty is associated with a history of falls in several cross-sectional studies. 19,23,35 Tsutsumimoto et al 78 also reported that PCDS is significantly associated with a history of falls and fall-related fractures.…”

Associations Between Intellectual and Social Activities With Frailty Among Community-Dwelling Older Adults in China: A Prospective Cohort Study

“…Previously, the preventive strategies mainly focused on physical-related interventions, such as taking regular physical activities and providing adequate nutritional intake ( 4 , 33 , 43 ). Recently, loneliness and social isolation have been proven to have negative effects on health ( 10 , 44 , 45 ). More attention should be paid to the association between psychosocial factors and frailty development.…”

“…The present study showed that participation in intellectual activity was associated with a significant decrease in frailty risk compared with non-participation in intellectual activity. Frailty often coexists with cognitive impairment ( 45 , 46 ). Lack of intellectual activity increases the risks of cognitive impairment ( 30 , 47 , 48 ).…”