Desempenho cognitivo e fragilidade em idosos clientes de operadora de saúde

Abstract

OBJECTIVE:To investigate the association between frailty syndrome and cognitive performance in the older adults and the effect of schooling and age on this association. METHODS:Data on frailty in older adults from Phase 1 of the FIBRA-RJ Study were analyzed, relating to 737 customers of a private health care provider, aged 65 and over, living in Rio de Janeiro, Southeastern Brazil, between January 2009 and January 2010. Data on socioeconomic and demographic characteristics, medical conditions and functional capacity were collected. Cognitive performance was assessed using the Mini-Mental State Examination (MMSE). Individuals who exhibited three or more of the following features were considered to be frail: unintentional weight loss (≥ 4.5 kg in the last year); feeling self-reported exhaustion, low grip strength, low physical activity level and slowness. The association between frailty and cognitive performance was evaluated using multivariate logistic regression, with adjustment for medical conditions, activities of daily living and socioeconomic variables. We evaluated the age and schooling as possible effect modifiers in this association. RESULTS:The frail subjects had a higher prevalence of low cognitive performance, compared to not frail or pre-frail, in the three age groups studied (65-74; 75-84; ≥ 85 years), p < 0.001. After adjustment, the association between frailty and cognitive performance was found among older adults individuals aged 75 and older, with an OR adj = 2.78 (95%CI 1.23;6.27) for those aged 75 to 84 and OR adj = 15.62 (95%CI 2.20;110.99) for 85 and older. The age variable was an effect modifier in the association between frailty and cognitive performance, χ² (5) = 806.97, p < 0.0001; the same was not the case with schooling. CONCLUSIONS:Frailty syndrome is associated with cognitive performance in the aging. Age proved to be an effect modifier in this association. The oldest patients showed a more significant association between the two phenomena.

Performance of Edmonton Frail Scale on frailty assessment: its association with multi-dimensional geriatric conditions assessed with specific screening tools

“…Specifically, the relationship between EFS and MMSE showed a significant association, as described previously in the literature by Kim et al in [33] and in the study by Faria et al [34], where the Odds Ratio of developing dementia increases with worsening frailty [33, 34]. …”

Association between cognitive impairment and criteria for frailty syndrome among older adults

“…A further FIBRA study analysis with 384 community-dwelling older adults confirmed that frailty and specific cognitive domains are linked, with a poorer performance as to time orientation and working memory prevalent among frail older adults 12 . Similar findings were observed in 737 participants of a study conducted in Rio de Janeiro City 13 and in a multi-centric Brazilian study 14 . Older adults with frailty had consistently lower Mini Mental State Examination (MMSE) scores compared to prefrail and robust older adults 13,14 .…”

“…Similar findings were observed in 737 participants of a study conducted in Rio de Janeiro City 13 and in a multi-centric Brazilian study 14 . Older adults with frailty had consistently lower Mini Mental State Examination (MMSE) scores compared to prefrail and robust older adults 13,14 . A systematic review with 29,664 participants in 19 studies, which were mostly conducted in Latin America, found that memory is the main function affected in older adults with frailty, and slowness and weakness are the most prevalent frailty clinical criteria in cognitively impaired older adults 15 .…”

Fragilidade física e desempenho cognitivo em populações idosas, parte I: revisão sistemática com metanálise

“…Individuals with higher levels of FS (pre-frail and frail) also have a higher risk of mortality when compared to non-frail elderly individuals. The results found in this study corroborate with the literature, it being increasingly evident that the FS is strongly related to cognitive status 22,26 . The present study makes it more evident that the pre-frail and frail groups, respectively, have a tendency to an imminent risk of suffering from more severe cognitive impairments, when the FS is detected.…”

“…An imminent consequence is the clinical outcomes related to mental health 20 , which can also be characterized by traumas caused by falls or a high fear (risk) of falling 21 , acute neurological outcomes triggered suddenly (dementia caused by a stroke) 22 , Alzheimer and/or Parkinson 19 . However, recent studies try to make it increasingly clear that there is an association between the FS and low cognitive profile or so-called mild cognitive impairment (MCI) 18,22 . This condition is characterized by the transient state between normal cognitive aging and mild dementia 23 .…”