Cognitive Frailty as a Predictor of Future Falls in Older Adults: A Systematic Review and Meta-Analysis

Guo, Xiaojing; Pei, Juhong; Ma, Yanhui; Cui, Yutong; Guo, Jiali; Wei, Yuting; Han, Lin

doi:10.1016/j.jamda.2022.10.011

Cited by 11 publications

(7 citation statements)

References 53 publications

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“…The results showed that the prevalence of cognitive frailty in elderly COPD patients was 19.3%, which was higher than the prevalence in older adults in mainland China, but lower than the results of Song's study. 14,24 The reason may be related to the fact that the proportion of male patients in this study sample was as high as 96.7%, and studies reported that the prevalence of cognitive frailty in elderly men was significantly lower than that in elderly women, and women had higher risks of cognitive frailty. 24 In addition, due to the large differences in the definition of cognitive frailty and the choice of assessment tools currently used by scholars, to a certain extent, this may also cause differences in the study results.…”

Section: Discussion High Prevalence Of Cognitive Frailty In Elderly C...mentioning

confidence: 86%

“…14,24 The reason may be related to the fact that the proportion of male patients in this study sample was as high as 96.7%, and studies reported that the prevalence of cognitive frailty in elderly men was significantly lower than that in elderly women, and women had higher risks of cognitive frailty. 24 In addition, due to the large differences in the definition of cognitive frailty and the choice of assessment tools currently used by scholars, to a certain extent, this may also cause differences in the study results. This study used the combination of the Fried Phenotype Scale and the MMSE, which is widely used, while Song 14 used the combination of other assessment tools.…”

Section: Discussion High Prevalence Of Cognitive Frailty In Elderly C...mentioning

confidence: 86%

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Risk factors of cognitive frailty in elderly chronic obstructive pulmonary disease patients and its implication for death: a cohort study

Wu,

Huang,

Jiang

et al. 2023

Psychogeriatrics

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BackgroundsCognitive frailty, a clinical syndrome with physical frailty and cognitive impairment, leads to mortality and other adverse health outcomes in older adults. This study aimed to investigate the prevalence of cognitive frailty, and its influencing factors, and follow its impact on short‐term mortality in elderly chronic obstructive pulmonary disease patients, to provide a theoretical scientific reference basis for clinical intervention and management of cognitive frailty.MethodsA sample of 243 elderly chronic obstructive pulmonary disease patients in the respiratory department of a tertiary care hospital was conveniently sampled from November 2021 to February 2023, and the prevalence of cognitive frailty was investigated using the General Information Survey Scale, the Fried Phenotype Scale, the Mini‐Mental State Examination, the Anxiety Self‐Rating Scale, the Brief Geriatric Depression Scale, and the Mortality Record. The mortality was recorded by telephone follow‐up after 6 months. A database was created and statistical analysis such as one‐way analysis of variance, logistic regression analysis, Kaplan–Meier, and Cox survival analysis were used to analyze the data.ResultsA total of 47 patients (19.3%) had cognitive frailty; there were statistical differences in the prevalence of cognitive frailty by medical payment type, physical exercise, and sleeping time (P < 0.05). During a 6‐month follow‐up, 38 patients (15.6%) died. Cox survival analysis showed that the risk of death in elderly chronic obstructive pulmonary disease patients in the cognitive frailty group was 3.212 times higher than that in the normal cognitive function and non‐frailty group (95% CI 1.646–6.270, P = 0.001), and 5.266 times higher than that in the normal cognitive function and frailty group (95% CI 3.159–8.778, P < 0.001).ConclusionsThe prevalence of cognitive frailty in elderly chronic obstructive pulmonary disease patients is high, and clinical staff should pay attention to patients' medical burden and financial ability, and reduce the incidence of cognitive frailty by instructing patients to perform physical exercise and arrange sleep time. Cognitive frailty is an important risk factor for mortality within 6 months in elderly chronic obstructive pulmonary disease patients, and early intervention should be emphasised to reduce or delay cognitive frailty and mortality.

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Section: Discussion High Prevalence Of Cognitive Frailty In Elderly C...mentioning

confidence: 86%

Section: Discussion High Prevalence Of Cognitive Frailty In Elderly C...mentioning

confidence: 86%

Risk factors of cognitive frailty in elderly chronic obstructive pulmonary disease patients and its implication for death: a cohort study

Wu,

Huang,

Jiang

et al. 2023

Psychogeriatrics

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“…Given the restricted access to resources for diagnostic workup in patients with IS and dementia [8, 31], it could be assumed that these patients may have less adequate secondary prevention, and they could also have less maintenance of it over time [32]. Moreover, it has been suggested that cognitive impairment could be associated with various adverse outcomes such future falls [33]. Finally, we did not measure cognitive deterioration over time secondary to stroke which has been shown to increase the risk of mortality [34].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Survival of Ischemic Stroke Patients according to Prior Cognitive Status: Dijon Stroke Registry

Béjot¹,

Pinguet²,

Duloquin³

2023

Neuroepidemiology

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Introduction: Understanding the influence of preexisting cognitive impairment on poststroke outcome is a critical challenge in a context of current aging and growing population. This study aimed to assess long-term survival of patients with acute ischemic stroke (IS) according to their premorbid cognitive status, and to identify contributing factors of death. Methods: Patients with IS were prospectively identified among residents of Dijon, France using a population-based registry (2013-2017). The association between case-fatality at 5 years and prestroke cognitive status was assessed by multivariable Cox models adjusted for other clinical characteristics and preexisting brain damage on initial CT-scan including leukoaraiosis, old vascular brain lesions, and cortical and central brain atrophy, as well as major arterial occlusion. Results: 1049 patients were included (mean age ±SD: 76.3 ±15.2 years old, 54% women). Case-fatality rates at 5 years were 38.1% in patients without cognitive impairment, 65.9% in patients with prior mild cognitive impairment (MCI, n=132, 12.6%), and 86.6% in patients with dementia (n=164, 15.6%) (p<0.001). MCI (HR=1.39; 95% CI: 1.06-1.81, p=0.016), and dementia (HR=1.89; 95% CI: 1.45-2.46, p<0.001 for dementia) were both independently associated with higher case-fatality after adjustment for clinical variables. The association remained significant after further adjustment for preexisting brain damage and major arterial occlusion (HR=1.47; 95% CI: 1.10-1.98, p=0.009 for MCI and HR=1.90; 95% CI: 1.43-2.53, p<0.001 for dementia) among patients with available data on CT-scan (n=916). Factors associated with death were roughly similar across groups. Conclusion: This study highlighted a poor long-term survival of IS patients with preexisting cognitive impairment, independently of other contributing factors of death. It is critical to better understand the trajectory of IS patients with preexisting cognitive impairment, and to identify prognostic markers to guide clinicians in their management strategies.

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“…Cognitive frailty, as one of the subtypes of frailty, is de ned as elderly syndrome with physical frailty and cognitive impairment under the premise of excluding dementia [6]. Previous researches have shown that cognitive frailty increases the risk of adverse outcomes, such as falls, disability, depression and mortality in the community-dwelling older adults [7][8][9][10][11]. However, the impact of cognitive frailty on postoperative recovery in elderly surgical patients remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Association of preoperative cognitive frailty with postoperative complications in elderly patients under general anesthesia: a prospective cohort study

FANG,

LIANG,

CHEN

et al. 2024

Preprint

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Background Cognitive frailty is defined as the coexistence of physical frailty and mild cognitive impairment, which is associated with adverse outcomes. Due to various factors such as age-related changes in the brain and the presence of comorbidities, the elderly are more susceptible to cognitive frailty. Objective To investigate the effect of preoperative cognitive frailty on postoperative complications in elderly patients. Methods This prospective observational study was conducted among 253 patients aged 60–85 years, who underwent elective orthopedic and abdominal surgery (postoperative hospital stay ≥ 3 days ) in the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from May 2023 to November 2023. Cognitive frailty was assessed using the MoCA for the cognitive status and the Fried criteria for five frailty scales. The participants were split into the following groups: group A, neither frail nor cognitive impairment; group B, only frailty ; group C, only cognitive impairment; group D, cognitive frailty. Primary outcome was the impact on postoperative complications. Secondary outcomes included mobility disability, prolonged hospital stay, 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 cognitive frailty 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. The difference was significant (P < 0.001). In the multivariate analysis, cognitive frailty [odds ratio (OR), 16.84; 95% confidence interval (CI), 4.54–62.37], only frailty (OR, 7.86; 95%CI, 2.12-29. 12), only cognitive impairment (OR, 4.22; 95%CI, 1.62–11.02). Conclusions Cognitive frailty was associated with higher risks of postoperative complications in elderly patients undergoing general anesthesia. It indicates that clinicians should pay much attention to these elderly with cognitive frailty.

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Cognitive Frailty as a Predictor of Future Falls in Older Adults: A Systematic Review and Meta-Analysis

Cited by 11 publications

References 53 publications

Risk factors of cognitive frailty in elderly chronic obstructive pulmonary disease patients and its implication for death: a cohort study

Risk factors of cognitive frailty in elderly chronic obstructive pulmonary disease patients and its implication for death: a cohort study

Long-Term Survival of Ischemic Stroke Patients according to Prior Cognitive Status: Dijon Stroke Registry

Association of preoperative cognitive frailty with postoperative complications in elderly patients under general anesthesia: a prospective cohort study

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