The Flexibility of Physio-Cognitive Decline Syndrome: A Longitudinal Cohort Study

Abstract

The mutual presence of impairments in physical and cognitive functions in older adults has been reported to predict incident disability, dementia, and mortality. The longitudinal transitions of phenotypes between these functional impairments, either individually or in combination, remain unclear. To investigate the natural course and prevalence of physical and/or cognitive impairments (CIs), we enrolled participants from a community-based population. Data were retrieved from the first (August 2011 and December 2012) and second wave (August 2013 and June 2015) of the I-Lan Longitudinal Aging Study (ILAS). All participants were classified into four groups: robust, mobility impairment (MI), CI, and physio-cognitive decline syndrome (PCDS). MI was diagnosed with weakness and/or slowness. CI was diagnosed if a subject met a cutoff below 1.5 standard deviations (SDs) of age-, sex-, and education-matched norms of any neuropsychological assessments. PCDS was combined with MI and CI. Our results showed that 38, 14, 30, and 18% of the participants were on the robust, MI, CI, and PCDS at the first wave, respectively. After 2.5 years, 17% robust, 29% MI, and 37% CI progressed to PCDS. In contrast, 33% of PCDS was reversed to non-PCDS. Predictors of conversion to PCDS included worse memory and language functions, older age, lower muscle mass, and the presence of diabetes. In PCDS, a stronger hand-grip strength, younger age, and better memory functions predicted reversion to non-PCDS status. In summary, we probed the transition of PCDS. The skeletal muscle mass/function and memory function are crucial factors associated with PCDS reversion or progression.

Physio-cognitive decline syndrome among middle-aged diabetes patients: Handgrip strength significantly correlates with glycaemic control and cognitive score

“…Subjects with PCDS in our study were surprisingly quite high (48.1 %), of which 64.1 % with uncontrolled glycaemia, while among uncontrolled glycaemia subjects there were 45.1 % subjects with PCDS. It may be the reason why the proportion of PCDS subjects was slightly higher among female than male subjects (50.7 vs. 45.5 %), as similar female dominance in other studies [ 9 , 11 , 29 ]. In contrast, Liang et al (2021) [ 9 ] reported 18.9 % PCDS among community-dwelling older adults with mean age of 74 (5.7) years.…”

Altered cerebellar and caudate gray‐matter volumes and structural covariance networks preceding dual cognitive and mobility impairments in older people

“…A recent collaborative effort, spearheaded by the National Institute on Aging (NIA), has underscored the necessity for a unified operational definition encompassing terms such as “MCR,” “PCDS,” and “dual decline in memory and gait” to facilitate progress in this field 14 . Notably, PCDS has been rigorously characterized and validated as a clinical phenotype within a substantial Asian population, characterized by well‐defined epidemiology, clinical trajectories, and outcomes 3,7–11,39,40 . Going forward, our focus will center on the application of PCDS criteria and/or the establishment of its substrate in more extensive and diverse cohorts.…”

“… 14 Notably, PCDS has been rigorously characterized and validated as a clinical phenotype within a substantial Asian population, characterized by well‐defined epidemiology, clinical trajectories, and outcomes. 3 , 7 , 8 , 9 , 10 , 11 , 39 , 40 Going forward, our focus will center on the application of PCDS criteria and/or the establishment of its substrate in more extensive and diverse cohorts. Furthermore, it should be noted that our study exclusively encompassed participants who underwent follow‐up, revealing a cohort that skews toward youth, higher education levels, reduced vascular risk factors, and superior baseline verbal memory performance in comparison to those not included in the follow‐up.…”

Association of Motoric Cognitive Risk Syndrome with Sarcopenia and Systemic Inflammation in Pre-Frail Older Adults

“…Handgrip strength, which is a measure of muscle strength and core determinant of sarcopenia, has been shown to predict 10-year cognitive decline [ 56 ]. Higher handgrip strength has been associated with larger hippocampal volume and transition to robust in the group with physio-cognitive decline syndrome [ 57 , 58 ]. Exercises which showed improvement in gait speed and handgrip strength also showed improvement in attention and cognition in community-dwelling older adults with MCR, further strengthening the intimate relationship between cognitive and physical function [ 18 , 59 ].…”