Disentangling Cognitive-Frailty: Results From the Gait and Brain Study

Montero‐Odasso, Manuel; Barnes, Brittany; Speechley, Mark; Hunter, Susan; Doherty, Timothy J.; Duque, Gustavo; Gopaul, Karen; Sposato, Luciano A.; Casas‐Herrero, Álvaro; Borrie, Michael; Camicioli, Richard; Wells, Jennie

doi:10.1093/gerona/glw044

Cited by 135 publications

(127 citation statements)

References 40 publications

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“…Even in the ‘ Gait and Brain study ’, conducted in 252 older adults free of dementia at baseline, the authors showed that those subjects displaying the combination of reduced walking speed and cognitive impairment ( n = 65, 26%) had the highest risk for progression to dementia (HR: 35.9, 95% CI: 4.0–319.2; P = 0.001, incident rate: 130/1000 person years).…”

Section: Prevalence Incidence and Clinical Impact Of The Motoric–comentioning

confidence: 99%

Prevalence, incidence, and clinical impact of cognitive–motoric risk syndrome in Europe, USA, and Japan: facts and numbers update 2019

Maggio

Lauretani

2019

J cachexia sarcopenia muscle

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A new syndrome called the ‘motoric–cognitive risk’ (MCR) syndrome has recently been proposed in older persons. According to this definition, the parallel impairment in muscle and brain function is more predictive for identifying subjects at risk of dementia than impairment a in single system alone. Epidemiological studies suggest that among older persons, enrolled in worldwide population‐based studies, 10% are affected by this syndrome, which confers a higher risk of future disability. In detail, the prevalence of MCR in Europe is around 8.0%, 7.0% in the United States, and 6.3% in Japan. The incidence of the MCR syndrome is estimated to be 65.2 per 1000 person years in adults aged 60 years or older. Many studies reported negative outcomes of the syndrome in older persons, emphasizing its clinical impact. In particular, in almost all longitudinal studies, MCR produces a three‐time increased risk of future dementia. In Europe, data from the InCHIANTI study report an increased risk of 2.74 [1.54–4.86], which is 2.49 [1.52–4.10] in the United States and 3.27 [1.55–6.90] in Japan. The studies in different continents are also consistent in showing an increased risk of all‐cause mortality, which is 1.50–1.87 in the Europeans and 1.69 [1.08–2.02] for incident disability in Japan. For the identification of the MCR syndrome, different tests and procedures have been proposed, with a final ‘core‐battery’ that includes gait speed, dual‐task gait speed, the Montreal Cognitive Assessment and Trail Making Test A and B. The criteria used to select this core‐battery were based on the best accuracy for identifying older persons at risk of negative outcomes such as dementia, falls, aging‐related disabilities, and sensitivity to interventions. The selection of these tests will allow to start studies aimed to better capture older persons at higher risk of mobility and cognitive disability. By these tests, it will be possible to better evaluate the effect of treatment composing of tailored physical exercise, nutritional suggestions, and medical therapy to overturn negative effect of both cognitive and motoric frailty. This article provides an overview of the current knowledge of the MCR syndrome.

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Section: Prevalence Incidence and Clinical Impact Of The Motoric–comentioning

confidence: 99%

Prevalence, incidence, and clinical impact of cognitive–motoric risk syndrome in Europe, USA, and Japan: facts and numbers update 2019

Maggio

Lauretani

2019

J cachexia sarcopenia muscle

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“…Design and logistics have been described in detail elsewhere [21]. Sociodemographic characteristics, comorbidities, prescribed medications, history of falls in the past 12 months, physical activity levels, and instrumental activities of daily living were collected using standardized questionnaires at all visits.…”

Section: Participant's Characteristics and Stratificationmentioning

confidence: 99%

Mild Cognitive Impairment Affects Obstacle Negotiation in Older Adults: Results from “Gait and Brain Study”

2018

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Background: Older adults with Mild Cognitive Impairment (MCI) are at higher risk of falls and injuries, but the underlying mechanism is poorly understood. Inappropriate anticipatory postural adjustments to overcome balance perturbations are affected by cognitive decline. However, it is unknown whether anticipatory gait control to avoid an obstacle is affected in MCI. Objective: Using the dual-task paradigm, we aim to assess whether gait control is affected during obstacle negotiation challenges in older adults with MCI. Methods: Seventy-nine participants (mean age = 72.0 ± 2.7 years; women = 30.3%) from the “Gait and Brain Study” were included in this study (controls = 27; MCI = 52). In order to assess the anticipatory control behaviour for obstacle negotiation, a 6-m electronic walkway embedded with sensors recorded foot prints to measure gait speed and step length variability, during early (3 steps before the late phase) and late (3 steps before the obstacle) pre-crossing phases of an ad hoc obstacle, set at 15% of participant’s height. Participants walked under single- and dual-task gait (counting backwards by 1’s from 100 while walking) conditions. Three-way mixed repeated-measures analysis of variance models examined differences in gait performance between groups when transitioning between pre-crossing phases towards an obstacle during single- and dual-task conditions. Analyses were adjusted for age, sex, years of education, lower limb function, fear of falling, medical status, depressive symptoms, baseline gait speed and executive function. Results: A significant three-way interaction among groups, pre-crossing phases and task showed that participants with MCI attenuated the gait deceleration (p = 0.02) and performed fewer step length adjustments (p = 0.03) when approaching the obstacle compared with controls while dual-tasking. These interactions were attenuated when executive function performance was added as a covariate in the adjusted statistical model. Conclusion: Older adults with MCI attenuate the anticipatory gait adjustments needed to avoid an obstacle when dual-tasking. Deficits in higher-order cognitive processing may limit obstacle negotiation capabilities in MCI populations, being a potential falls risk factor.

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“…Based on different combinations of these biomarkers and the decline of mental function, the cognitive frailty and various preclinical stages of AD may be recognized (Sperling et al, 2013; Ruan et al, 2015). There are a number of studies indicating that physical frailty is a risk factor of cognitive frailty, which in turn is a predictor of overall dementia, particularly vascular dementia (Giannini et al, 2015; Montero-Odasso et al, 2016; Feng et al, 2017). However, precisely how physical frailty or pre-frailty causes cognitive decline is not known (Kelaiditi et al, 2014; Panza et al, 2015; Ruan et al, 2015).…”

Section: Aging Is In the Mind—how To Change The Mind?mentioning

confidence: 99%

Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article

Sacha

Soboń

et al. 2017

Front. Physiol.

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Frailty is a state that encompasses losses in physical, psychological or social domains. Therefore, frail people demonstrate a reduced potential to manage external stressors and to respond to life incidents. Consequently, such persons are prone to various adverse consequences such as falls, cognitive decline, infections, hospitalization, disability, institutionalization, and death. Pre-frailty is a condition predisposing and usually preceding the frailty state. Early detection of frailty (i.e., pre-frailty) may present an opportunity to introduce effective management to improve outcomes. Exercise training appears to be the basis of such management in addition to periodic monitoring of food intake and body weight. However, various nutritional supplements and other probable interventions, such as treatment with vitamin D or androgen, require further investigation. Notably, many societies are not conscious of frailty as a health problem. In fact, people generally do not realize that they can change this unfavorable trajectory to senility. As populations age, it is reasonable to begin treating frailty similarly to other population-affecting disorders (e.g., obesity, diabetes or cardiovascular diseases) and implement appropriate preventative measures. Social campaigns should inform societies about age-related frailty and pre-frailty and suggest appropriate lifestyles to avoid or delay these conditions. In this article, we review current information concerning therapeutic interventions in frailty and pre-frailty and discuss whether a greater public awareness of such conditions and some preventative and therapeutic measures may decrease their prevalence.

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Disentangling Cognitive-Frailty: Results From the Gait and Brain Study

Cited by 135 publications

References 40 publications

Prevalence, incidence, and clinical impact of cognitive–motoric risk syndrome in Europe, USA, and Japan: facts and numbers update 2019

Prevalence, incidence, and clinical impact of cognitive–motoric risk syndrome in Europe, USA, and Japan: facts and numbers update 2019

Mild Cognitive Impairment Affects Obstacle Negotiation in Older Adults: Results from “Gait and Brain Study”

Is It Time to Begin a Public Campaign Concerning Frailty and Pre-frailty? A Review Article

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