Cognitive frailty in community‐dwelling older Japanese people: Prevalence and its association with falls

Abstract

Aim To investigate the prevalence and associated factors of cognitive frailty and cognitive frailty‐related falls in community‐dwelling older people. Methods A total of 25 out of 1192 community‐dwelling older people aged >70 years with cognitive frailty participated in the present cross‐sectional study. Cognitive function was assessed using the Mini‐Mental State Examination. Physical function measures included calf circumference, Timed Up and Go (TUG) and usual walking speed. Interviews were carried out to assess Council on Nutrition Appetite Questionnaire (CNAQ); chronic diseases including hypertension, diabetes and falls; as well as physical frailty, defined as having three of five criteria: muscle weakness, slowness, exhaustion, low activity and weight loss. Results The prevalence of cognitive frailty was 2.1%. Participants with cognitive frailty had significantly reduced Mini‐Mental State Examination and calf circumference; and higher instrumental activities of daily living disability and falls. Old age (OR 1.151, 95% CI 1.053–1.257), fall history (OR 3.577, 95% CI 1.381–9.263), having four or more chronic diseases (OR 7.419, 95% CI 2.117–26.005) and slower TUG (OR 1.234, 95% CI 1.041–1.462) were significantly associated with cognitive frailty, whereas greater calf circumference (OR 0.748, 95% CI 0.625–0.895) and CNAQ (OR 0.736, 95% CI 0.628–0.8631) had protective effects. Old age (OR 1.132, 95% CI 1.002–1.280), hospitalization (OR 10.090, 95% CI 2.554–39.854), having four or more chronic diseases (OR 5.120, 95% CI 1.113–23.557) and slower TUG (OR 1.394, 95% CI 1.167–1.665) were significantly associated with cognitive frailty‐related falls, whereas CNAQ (OR 0.704, 0.571–0.868) had protective effects. Conclusions Age, chronic disease, TUG and CNAQ were significantly associated with cognitive frailty and cognitive frailty‐related falls. The TUG and CNAQ have the greatest potential for improvement by intervention or lifestyle change. Further research is necessary to determine the efficacy of positive changes in these factors for symptomatic improvements. Geriatr Gerontol Int 2019; 19: 647–653.

What Role Does Activity Engagement Play in the Association between Cognitive Frailty and Falls among Older Adults? Evidence from Rural Shandong, China

“…According to the data from Chinese Longitudinal Survey on Urban and Rural Elderly, the proportion of rural elderly people > 75 years old was 46.7%, which indicated a relatively older age structure [4]. Our results manifested that cognitive frailty was positively associated with falls among rural older adults in Shandong, China, in agreement with previous studies [7,8]. The higher the degree of cognitive frailty, the more likely falls are experienced.…”

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

“…Shrinking was defined as unwanted weight loss of a minimum of 1 kg a week over two consecutive weeks or more, or a body mass index of <18.5 kg/m 2 ( 19 ). Weakness was defined as low hand grip strength, as measured with JAMAR hand dynamometer (Jamar Plus +Digital 563213; Lafayette Instrument Company, Lafayette, IN, USA) of <18.0 kg for women and <26.0 kg for men ( 20 ). Single-task walking at usual speed was mentioned in the “Walking paradigm.” A slow walking speed was defined as a usual walking speed of <1.0 m/s, as measured by a wearable gait monitor (Intelligent Device for Energy Expenditure and Activity [IDEEA]) ( 20 , 21 ).…”

“…Weakness was defined as low hand grip strength, as measured with JAMAR hand dynamometer (Jamar Plus +Digital 563213; Lafayette Instrument Company, Lafayette, IN, USA) of <18.0 kg for women and <26.0 kg for men ( 20 ). Single-task walking at usual speed was mentioned in the “Walking paradigm.” A slow walking speed was defined as a usual walking speed of <1.0 m/s, as measured by a wearable gait monitor (Intelligent Device for Energy Expenditure and Activity [IDEEA]) ( 20 , 21 ). Exhaustion was defined as a negative response to the following question in the Geriatric Depression Scale ( 22 ): “Do you feel full of energy?” Low physical activity was defined as not engaging in physical exercise at least once weekly ( 23 ).…”

“…Single-task walking at usual speed was mentioned in the "Walking paradigm." A slow walking speed was defined as a usual walking speed of <1.0 m/s, as measured by a wearable gait monitor (Intelligent Device for Energy Expenditure and Activity [IDEEA]) (20,21). Exhaustion was defined as a negative response to the following question in the Geriatric Depression Scale (22): "Do you feel full of energy?"…”

“…Cognitive function was evaluated with the Mini-Mental State Examination. Participants with scores >27 points were categorized as "normal"; 19-26 points as having mild cognitive impairment; and <18 points as having dementia (20).…”