Cognitive Function in the Prefrailty and Frailty Syndrome

Abstract

Objectives To explore the relationship between cognitive function and frailty. Design A cross‐sectional study using data from Wave 1 of The Irish Longitudinal Study on Ageing, a population representative study of adults aged 50 and older in the Republic of Ireland. Setting Community‐dwelling adults completed a home‐ or health center–based nurse‐led assessment. Participants Individuals aged 50 and older without a history of stroke, Parkinson's disease, or severe cognitive impairment (Mini‐Mental State Examination (MMSE) score <18) and not taking antidepressants (N = 4,649). Measurements A cognitive battery including MMSE, Montreal Cognitive Assessment, Color Trails Test, Cambridge Mental Disorders of the Elderly Examination memory and executive function subtests, 10‐word recall, Sustained Attention to Response Task, and choice reaction time was used to generate composite scores of cognitive domains. Frailty was assessed according to weakness, slowness, exhaustion, low physical activity, and weight loss. Results After full adjustment, cognitive function across all domains except self‐rated memory and processing speed was significantly worse in prefrail and frail participants (P < .05) than in those who were robust. Weakness and walking speed were most consistently linked to poorer cognition, whereas low activity and weight loss were not independently associated with any cognitive domain. Exhaustion was associated with global cognition (B = −0.18 ± 0.06), with some evidence of links to objectively measured and self‐rated memory. Conclusion Cognitive function is worse across multiple cognitive domains in prefrail and frail individuals aged 50 and older than in those who are robust, although the absolute differences are small after adjusting for confounding factors.

Frailty and Cognitive Function in Incident Hemodialysis Patients

“…Although previous studies of adults with CKD have found that lower kidney function is associated with worse cognitive function (36,37), we have identified a high-risk subgroup of patients with ESRD: namely, those who are frail who have more profound cognitive loss. Our findings add some support for the association between frailty and cognitive function, cognitive decline, and dementia observed in frail middle-aged and older adults (3,(7)(8)(9)(10)(11)(12)(13)(14) and extend these findings to adults of all ages undergoing hemodialysis. Similar to a cross-sectional study of older adults, we found that frailty was associated with multiple domains of cognition, not just global cognitive function (10).…”

“…Our findings add some support for the association between frailty and cognitive function, cognitive decline, and dementia observed in frail middle-aged and older adults (3,(7)(8)(9)(10)(11)(12)(13)(14) and extend these findings to adults of all ages undergoing hemodialysis. Similar to a cross-sectional study of older adults, we found that frailty was associated with multiple domains of cognition, not just global cognitive function (10). However, global cognitive function at 1 year after hemodialysis initiation may be worse for frail adults undergoing hemodialysis because it represents overall function rather than domain-specific function, as is measured by TMTA/TMTB.…”

“…Poor cognitive function may be one pathway linking frailty to adverse outcomes on hemodialysis. Although there is some evidence that frailty is associated with poor cognitive function (3,(7)(8)(9)(10), cognitive decline (11,12), and dementia (13,14) in middle-aged and older adults, the association between frailty and cognitive function in adults of all ages undergoing hemodialysis is unclear. We hypothesize that frail adults initiating hemodialysis are more likely to have worse cognitive function.…”

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

“…6 Some studies showed the importance of assessing frailty in older people, including older caregivers, since it might predict disability, dementia and death. [7][8][9] Some complicating factors related to caregiving should be highlighted, e.g., being over 60 years old and living on non-urban areas, where formal support is more difficult to be found.…”

Rural–urban differences in the prevalence of cognitive impairment in independent community-dwelling elderly residents of Ojiya city, Niigata Prefecture, Japan

“…Cognitive impairment, including mild cognitive impairment (MCI: the early or intermediate stages of dementia) and dementia, poses a public health burden in society, and those with cognitive impairment are prone to age-related frailty [3], which can increase care costs [4]. Therefore, epidemiological profiles of cognitive impairment in communities warrant researching.…”