Frailty as a Predictor of Cognitive Disorders: A Systematic Review and Meta-Analysis

Borges, Marcus Kiiti; Canevelli, Marco; Cesari, Matteo; Aprahamian, Ivan

doi:10.3389/fmed.2019.00026

Cited by 139 publications

(101 citation statements)

References 50 publications

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“…Our study results indicate that physical frailty predicts CF better than MCI does. This concurs with previous reports showing the directional relationship of cognitive impairment, which was caused by physical impairments and not by the presence of concomitant neurological impairments [8,70]. In a longitudinal study, frail individuals with normal cognition were detected to have cognitive impairment after a 5-years follow-up and were associated with a greater risk of developing dementia of the AD type [71].…”

Section: Discussionsupporting

confidence: 91%

Incidence and Predictors of Cognitive Frailty Among Older Adults: A Community-based Longitudinal Study

Rivan

Shahar

Rajab

et al. 2020

IJERPH

104

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1) Background: Cognitive frailty (CF) is the simultaneous presence of physical frailty and cognitive impairment with an increased risk of dementia. Considering that the risk factors of CF are mostly elucidated from cross-sectional studies, we conducted a community-based longitudinal study to determine the incidence and the predictors of CF among Malaysian older adults.; (2) Methods: Out of 490 older adults participating in the Malaysian Towards Useful Aging (TUA) study, 282 were successfully followed-up at five-years for an analysis of the CF incidence. CF was defined as a comorbid physical frailty (>1 Fried criteria) and mild cognitive impairment (Petersen criteria). A comprehensive interview-based questionnaire was administered for sociodemographic information, cognitive function, physical function, dietary intake, psychosocial, and biochemical indices. Univariate analyses were performed for each variable, followed by a regression analysis to identify the predictors of CF that accounted for confounding effects between the studied factors; (3) Results: The incidence Int.rate of CF was 7.1 per 100 person-years. Advancing age (OR=1.12, 95% CI:1.04-1.21, p < 0.05), depression (OR=1.20, 95% CI:1.05-1.37, p < 0.05), decreased processing speed, assessed by a lower digit symbol score (OR=0.67, 95%CI:0.0.56-0.80, p < 0.05), decreased functional mobility measured using Timed-Up-and-Go (TUG) (OR=1.23, 95% CI:1.04-1.46, p < 0.05), low vitamin D intake (OR:0.36, 95% CI:0.14-0.93, p < 0.05) and physical frailty (OR=2.16, 95% CI:1.02-4.58, p < 0.05) were predictors for CF incidence; and (4) Conclusions: Our study results could be used as an initial reference for future studies to formulate effective preventive management and intervention strategies to decelerate CF development among older adults.

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Section: Discussionsupporting

confidence: 91%

Incidence and Predictors of Cognitive Frailty Among Older Adults: A Community-based Longitudinal Study

Rivan

Shahar

Rajab

et al. 2020

IJERPH

104

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“…We were surprised to find that the prevalence of cognitive impairment is up to 20.57% among elderly inpatients and 26.94% of the frail population. Geriatric cognitive disorders were significantly associated with an increased risk of frailty, which was consistent with other studies [37,38,39] The prevalence and risk factors could be compared across different geographic regions, used as a public health indicator of 'Ageing well', and examined as a heath equity indicator and related to GDP of the city/region and/or accessibility and adequacy of healthcare provisions. Frailty can potentially be prevented or treated with specific modalities, such as exercise, protein-calorie supplementation, vitamin D, and reduction of polypharmacy [43].…”

Section: Discussionsupporting

confidence: 86%

Prevalence and Associated Factors for Frailty among Elder Patients in China: A multicenter cross-sectional study

Jiao

Wang

Zhu

et al. 2020

Preprint

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Background: Up to date, most of previous studies of frailty among hospitalized elder Chinese patients were conducted based on a small sample, which could not represent the elder patient population. The aim of this study is to identify the prevalence and the risk factors for frailty among elder patients in China. Study Design and Setting: This is a cross-sectional study, 9996 elder patients from 6 tertiary level hospitals in China were surveyed. The prevalence of frailty among patients from selected wards was surveyed by trained investigators. Mixed-effect Poisson regression model were used to analyze the associated factors of frailty among elder patients. Results: The mean age of all subjects was72.47±5.77years. The prevalence rate of frailty in this study was 18.02%. After controlling the confounding effect of hospital wards clustering effect, Mixed-effect Poisson regression model showed that the associated factors of frailty included: age(OR:1.016, 95% CI:1.012 -1.020), patients with BMI < 18.5(OR: 1.248, 95% CI:1.171-1.330), female(OR:1.058, 95% CI:1.004 -1.115), ethnic minorities(OR: 1.152, 95% CI: 1.073-1.236), admission to hospital by the emergency department(OR: 1.104, 95% CI:1.030 -1.184),the former drinker(OR: 1.094, 95% CI:1.022 -1.171),fall history in past 12 month(OR:1.257, 95%CI:1.194-1.323),vision dysfunction(OR:1.144 , 95% CI:1.080 -1.211),cognition impairment(OR:1.182 , 95% CI:1.130 -1.237),sleeping dysfunction(OR:1.215, 95% CI:1.215 -1.318),urinary dysfunction(OR: 1.175, 95% CI:1.104 -1.251),defecation dysfunction(OR:1.286 , 95% CI:1.217 -1.358). Conclusion: We identified a relatively high prevalence of frailty among elder patients, and there are several associate factors among the population derived from an investigation of a large-scale, multicenter, nationwide representative Chinese elderly inpatient population. Trial registration: Chinese clinical Trial registry, ChiCTR1800017682, Registered 09 August 2018 Keywords: Frailty; Elder patients; Prevalence; Associate factors

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“…Second, frailty and dementia might have a similar aetiological pathway because both are related to cognitive decline [41]. The aetiology of frailty is multidimensional, including nutrition, physical activity, coping, social support and other potential causes [44,45]. Inflammation, oxidative stress and cortical atrophy are three factors that play essential roles in the development of both dementia and frailty [46].…”

Section: Discussionmentioning

confidence: 99%

The association between frailty and incidence of dementia in Beijing: findings from 10/66 dementia research group population-based cohort study

Huang

Liu

et al. 2020

BMC Geriatr

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Background: The relationship between frailty and dementia is unclear and there are very few population-based studies regarding this issue in China. The purpose of this study is to estimate the association between frailty and incident dementia in China, and to explore different effects of frailty established by three definitions of frailty on dementia incidence. Methods: A five-year prospective cohort study was carried out in 2022 participants aged 65 years and over in urban and rural sites in Beijing, China. The participants were interviewed by trained community primary health care workers from 2004 to 2009. Frailty was defined using modified Fried frailty phenotype, physical frailty definition, and multidimensional frailty definition. Dementia was diagnosed using the 10/66 dementia criterion for calculating cumulative incidence. Both competing risk regression models and Cox proportional hazards models were applied to examine the associations between frailty at baseline and five-year cumulative incidence of dementia. Results: At the end of follow-up the five-year cumulative incidence rates of dementia with frailty and without frailty defined by the modified Fried frailty were 21.0% and 9.6%, those defined by the physical frailty were 19.9% and 9.0%, and those defined by the multidimensional frailty were 22.8% and 8.9%, respectively. Compared with non-frail participants, frail people had a higher risk of incident dementia using multidimensional frailty definition after adjusting covariates based on competing risk regression model (HR = 1.47, 95% CI 1.01~2.17) and Cox proportional hazards model (HR = 1.56, 95% CI 1.07~2.26). The association between frailty and incident dementia was statistically significant in participants in the upper three quartiles of age (aged 68 years and over) using the multidimensional frailty definition based on the competing risk regression model (HR = 1.61, 95% CI 1.06~2.43) and Cox proportional hazard model (HR = 1.76, 95% CI 1.19~2.61).

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Frailty as a Predictor of Cognitive Disorders: A Systematic Review and Meta-Analysis

Cited by 139 publications

References 50 publications

Incidence and Predictors of Cognitive Frailty Among Older Adults: A Community-based Longitudinal Study

Incidence and Predictors of Cognitive Frailty Among Older Adults: A Community-based Longitudinal Study

Prevalence and Associated Factors for Frailty among Elder Patients in China: A multicenter cross-sectional study

The association between frailty and incidence of dementia in Beijing: findings from 10/66 dementia research group population-based cohort study

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