Frailty syndrome and the risk of vascular dementia: The Italian Longitudinal Study on Aging

Solfrizzi, Vincenzo; Scafato, Emanuele; Frisardi, Vincenza; Seripa, Davide; Logroscino, Giancarlo; Maggi, Stefania; Imbimbo, Bruno P.; Galluzzo, Lucia; Baldereschi, Marzia; Gandin, Claudia; Carlo, Antonio Di; Inzitari, Domenico; Crepaldi, Gaetano; Pilotto, Alberto; Panza, Francesco

doi:10.1016/j.jalz.2011.09.223

Cited by 150 publications

(118 citation statements)

References 47 publications

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“…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.…”

Section: Introductionmentioning

confidence: 99%

Frailty and Cognitive Function in Incident Hemodialysis Patients

McAdams‐DeMarco¹,

Tan²,

Salter³

et al. 2015

Clinical Journal of the American Society of Nephrology

161

136

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Background and objectives Patients of all ages undergoing hemodialysis (HD) have a high prevalence of cognitive impairment and worse cognitive function than healthy controls, and those with dementia are at high risk of death. Frailty has been associated with poor cognitive function in older adults without kidney disease. We hypothesized that frailty might also be associated with poor cognitive function in adults of all ages undergoing HD.Design, setting, participants, & measurements At HD initiation, 324 adults enrolled (November 2008 to July 2012) in a longitudinal cohort study (Predictors of Arrhythmic and Cardiovascular Risk in ESRD) were classified into three groups (frail, intermediately frail, and nonfrail) based on the Fried frailty phenotype. Global cognitive function (3MS) and speed/attention (Trail Making Tests A and B [TMTA and TMTB, respectively]) were assessed at cohort entry and 1-year follow-up. Associations between frailty and cognitive function (at cohort entry and 1-year follow-up) were evaluated in adjusted (for sex, age, race, body mass index, education, depression and comorbidity at baseline) linear (3MS, TMTA) and Tobit (TMTB) regression models.Results At cohort entry, the mean age was 54.8 years (SD 13.3), 56.5% were men, and 72.8% were black. The prevalence of frailty and intermediate frailty were 34.0% and 37.7%, respectively. The mean 3MS was 89.8 (SD 7.6), TMTA was 55.4 (SD 29), and TMTB was 161 (SD 83). Frailty was independently associated with lower cognitive function at cohort entry for all three measures (3MS: 22.4 points; 95% confidence interval [95% CI], 24.2 to 20.5; P=0.01; TMTA: 12.1 seconds; 95% CI, 4.7 to 19.4; P,0.001; and TMTB: 33.2 seconds; 95% CI, 9.9 to 56.4; P=0.01; all tests for trend, P,0.001) and with worse 3MS at 1-year follow-up (22.8 points; 95% CI, 25.4 to 20.2; P=0.03). ConclusionsIn adult incident HD patients, frailty is associated with worse cognitive function, particularly global cognitive function (3MS).

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Section: Introductionmentioning

confidence: 99%

Frailty and Cognitive Function in Incident Hemodialysis Patients

McAdams‐DeMarco¹,

Tan²,

Salter³

et al. 2015

Clinical Journal of the American Society of Nephrology

161

136

View full text Add to dashboard Cite

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“…Probablemente algunos mecanismos inflamatorios están implicados en la relación de ambos problemas, así como cambios vasculares, los cuales pueden favorecer el deterioro de la cognición. Esta aseveración resulta de las conclusiones de dos estudios epidemiológicos que señalan a la fragilidad como un factor de riesgo de demencia de tipo vascular 41,42 . Uno de ellos incluyó 5248 participantes (de 65 a 95 años) y se interesó en el estudio de la relación entre este síndrome geriátrico y la incidencia de demencia de tipo vascular.…”

Section: Fragilidad Y Deterioro Cognitivounclassified

“…Después de 7 años de seguimiento, aquellos sujetos que fueron frágiles al entrar en el estudio y no tenían demencia tuvieron un mayor riesgo de desarrollar demencia vascular (HR: 2.73; IC 95%: 1.05-7.13) incluso tras el ajuste por múltiples confusores; este estudio concluyó que la fragilidad es un factor de riesgo mayor de presentar este tipo de demencia 41 . El mismo hallazgo fue replicado por un estudio italiano con una media de seguimiento de 3.5 años, en el cual la fragilidad también resultó como un factor de riesgo para demencia de tipo vascular, incluso después de ser ajustado por posibles confusores (HR: 2.68; IC 95%: 1.16-7.17) 42 . A la luz de estos resultados, se ha considerado la expresión de la fragilidad como un estado prodrómico de la demencia vascular, lo cual se ve apoyado por los resultados de un estudio que muestra que los cambios vasculares, tales como el mayor grosor de la íntima-media de la carótida, así como el mayor diámetro de la luz carotídea (evidenciados por ultrasonografía Doppler), son más frecuentes en personas frágiles en comparación con las no frágiles 43 .…”

Section: Fragilidad Y Deterioro Cognitivounclassified

Deterioro cognitivo en adultos mayores con VIH/sida y síndrome de fragilidad

Zamudio-Rodríguez

Aguilar-Navarro

Ávila-Funes

2017

GMM

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“…This is atributed to multiple causes including increased rates of Alzheimer's disease (AD), mild cognitive impairment, and a distinct subtype of frailty-cognitive frailty [62,63]. Cognitive frailty is a clinical syndrome found in elderly patients without AD or other dementias, and occurs concurrently with physical frailty [63].…”

Section: Frailty and Cerebrovascular Diseasementioning

confidence: 99%

“…Frail patients were also more likely to have any form of dementia (HR 1.85; 95% CI: 1.01-3.40) and vascular dementia in particular (HF 2.68; 95% CI: 1.16-7.17) [62]. Frail patients are 3.38 times (95% CI: 2.37-4.81, p < 0.001) more likely to have a stroke or TIA than non-frail patients [60].…”

Section: Frailty and Cerebrovascular Diseasementioning

confidence: 99%

Frailty and Cardiovascular Disease

Chainani¹,

Riehl²,

Chainani³

et al. 2017

Frailty and Sarcopenia - Onset, Development and Clinical Challenges

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Cardiovascular disease (CVD) comprises a vast spectrum of disease states ranging from hypertension (HTN) to valvular heart disease (VHD). CVD is known to be the leading cause of morbidity, mortality, and health-care expenditure throughout the world. According to the World Health Organization, coronary artery disease (CAD) and stroke, both subsets of CVD, are the world's biggest killers, accounting for a combined 15 million deaths in 2015. These diseases have remained the leading causes of death globally in the last 15 years. In 2010, CAD alone was projected to cost the U.S. $108.9 billion including the cost of health-care services, medications, and lost productivity. The presence of frailty signiicantly worsens outcomes for patients sufering from CAD. With just this one example of how frailty afects CVD, it is clear that understanding the impact of frailty upon patients alicted with the spectrum of cardiovascular disease is integral for the care of this very signiicant patient population.

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Frailty syndrome and the risk of vascular dementia: The Italian Longitudinal Study on Aging

Abstract: In our large population-based sample, frailty syndrome was a short-term predictor of overall dementia and VaD.

Cited by 150 publications

References 47 publications

Frailty and Cognitive Function in Incident Hemodialysis Patients

Frailty and Cognitive Function in Incident Hemodialysis Patients

Deterioro cognitivo en adultos mayores con VIH/sida y síndrome de fragilidad

Frailty and Cardiovascular Disease

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