Correlation of physical and cognitive impairment in diabetic and hypertensive frail older adults

Abstract

Background Diabetes and hypertension are common in older adults and represent established risk factors for frailty. Frailty is a multidimensional condition due to reserve loss and susceptibility to stressors with a high risk of death, hospitalizations, functional and cognitive impairment. Comorbidities such as diabetes and hypertension play a key role in increasing the risk of mortality, hospitalization, and disability. Moreover, frail patients with diabetes and hypertension are known to have an increased risk of cognitive and physical impairment. Nevertheless, no study assessed the correlation between physical and cognitive impairment in frail older adults with diabetes and hypertension. Methods We evaluated consecutive frail older patients with diabetes and hypertension who presented at ASL (local health unit of the Italian Ministry of Health) Avellino, Italy, from March 2021 to October 2021. The inclusion criteria were: a previous diagnosis of diabetes and hypertension with no evidence of secondary causes; age > 65 years; a frailty status; Montreal Cognitive Assessment (MoCA) score < 26. Results 179 patients successfully completed the study. We found a strong and significant correlation between MoCA score and 5-m gait speed test (r: 0.877; p < 0.001). To further verify our results, we performed a linear multivariate analysis adjusting for potential confounding factors, with MoCA score as dependent variable, which confirmed the significant association with glycemia (p < 0.001). Conclusions This is the first study showing a significant correlation between 5-m gait speed test and MoCA score in frail diabetic and hypertensive older adults.

Adherence to Medication in Older Adults with Type 2 Diabetes Living in Lubuskie Voivodeship in Poland: Association with Frailty Syndrome

“…In recent years, researchers have repeatedly addressed the coexistence of frailty and diabetes in the elderly [ 23 , 24 , 25 , 26 ]. This problem was considered in the context of the impact of these diseases on the quality of life [ 5 ], cognitive and functional status [ 27 , 28 , 29 ], or on the results of clinical trials of these patients [ 29 ]. There are also studies in the literature focusing on the problem of non-adherence in various chronic diseases such as: COPD (chronic obstructive pulmonary disease [ 30 ], DM2 [ 31 , 32 , 33 ], chronic kidney disease [ 34 ], hypertension [ 35 ] or rheumatic heart disease [ 36 ], etc.…”

Global cognitive function correlates with P‐wave dispersion in frail hypertensive older adults

“…Physical frailty assessment was performed following the Fried criteria 8 , 36 ; a diagnosis of frailty status was made with at least three points out of the following five: Weight loss (unintentional loss ≥4.5 kg in the past year); Weakness (handgrip strength in the lowest 20% quintile at baseline, adjusted for sex and body mass index); Exhaustion (poor endurance and energy, self‐reported); Slowness (walking speed under the lowest quintile adjusted for sex and height); Low physical activity level (lowest quintile of kilocalories of physical activity during the past week). …”

L-Arginine Improves Cognitive Impairment in Hypertensive Frail Older Adults

“…Global cognitive function was assessed using the MoCA test, with scores ranging from 0 to 30 (lower scores indicate cognitive impairment), as we previously described ( 35 ); this cognitive test covers the main cognitive areas: immediate and delayed memory (free and cued recall), language, visuospatial and visuoperceptual capacities, motor planning, executive function, attention, and cognitive judgment ( 36 – 38 ).…”