A Longitudinal Study on the Association of Interrelated Factors Among Frailty Dimensions, Cognitive Domains, Cognitive Frailty, and All-Cause Mortality

2021 ◽  
pp. 1-15
Author(s):  
Jen-Hau Chen ◽  
Hua-San Shih ◽  
Jennifer Tu ◽  
Jeng-Min Chiou ◽  
Shu-Hui Chang ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Cognitive Domains ◽  
Domain Specific ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Global Cognition ◽  
Definition Of ◽  
Over Time

Background: Cognitive frailty integrating impaired cognitive domains and frailty dimensions has not been explored. Objective: This study aimed to explore 1) associations among frailty dimensions and cognitive domains over time and 2) the extended definitions of cognitive frailty for predicting all-cause mortality. Methods: This four-year cohort study recruited 521 older adults at baseline (2011–2013). We utilized 1) generalized linear mixed models exploring associations of frailty dimensions (physical dimension: modified from Fried et al.; psychosocial dimension: integrating self-rated health, mood, and social relationship and support; global frailty: combining physical and psychosocial frailty) with cognition (global and domain-specific) over time and 2) time-dependent Cox proportional hazard models assessing associations between extended definitions of cognitive frailty (cognitive domains-frailty dimensions) and all-cause mortality. Results: At baseline, the prevalence was 3.0%for physical frailty and 37.6%for psychosocial frailty. Greater physical frailty was associated with poor global cognition (adjusted odds ratio = 1.43–3.29, β: –1.07), logical memory (β: –0.14 to –0.10), and executive function (β: –0.51 to –0.12). Greater psychosocial frailty was associated with poor global cognition (β: –0.44) and attention (β: –0.15 to –0.13). Three newly proposed definitions of cognitive frailty, “mild cognitive impairment (MCI)-psychosocial frailty,” “MCI-global frailty,” and “impaired verbal fluency-global frailty,” outperformed traditional cognitive frailty for predicting all-cause mortality (adjusted hazard ratio = 3.49, 6.83, 3.29 versus 4.87; AIC = 224.3, 221.8, 226.1 versus 228.1). Conclusion: Notably, extended definitions of cognitive frailty proposed by this study better predict all-cause mortality in older adults than the traditional definition of cognitive frailty, highlighting the importance of psychosocial frailty to reduce mortality in older adults.

scholarly journals Physical Frailty and Amyloid-β Deposits in the Brains of Older Adults with Cognitive Frailty

2018 ◽  
Vol 7 (7) ◽  
pp. 169 ◽  
Author(s):  
Dong Yoon ◽  
Jun-Young Lee ◽  
Seong Shin ◽  
Yu Kim ◽  
Wook Song
Keyword(s):  
Older Adults ◽  
Amyloid Β ◽  
Physical Frailty ◽  
Cognitive Frailty

scholarly journals Deviations in Hippocampal Subregion in Older Adults With Cognitive Frailty

2021 ◽  
Vol 12 ◽  
Author(s):  
Mingyue Wan ◽  
Yu Ye ◽  
Huiying Lin ◽  
Ying Xu ◽  
Shengxiang Liang ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Molecular Layer ◽  
Chinese Version ◽  
Healthy Controls ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Significant Volume ◽  
The Right ◽  
Volume Decrease

BackgroundCognitive frailty is a particular state of cognitive vulnerability toward dementia with neuropathological hallmarks. The hippocampus is a complex, heterogeneous structure closely relates to the cognitive impairment in elderly which is composed of 12 subregions. Atrophy of these subregions has been implicated in a variety of neurodegenerative diseases. The aim of this study was to explore the changes in hippocampal subregions in older adults with cognitive frailty and the relationship between subregions and cognitive impairment as well as physical frailty.MethodsTwenty-six older adults with cognitive frailty and 26 matched healthy controls were included in this study. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA) scale (Fuzhou version) and Wechsler Memory Scale-Revised Chinese version (WMS-RC), while physical frailty was tested with the Chinese version of the Edmonton Frailty Scale (EFS) and grip strength. The volume of the hippocampal subregions was measured with structural brain magnetic resonance imaging. Partial correlation analysis was carried out between the volumes of hippocampal subregions and MoCA scores, Wechsler’s Memory Quotient and physical frailty indexes.ResultsA significant volume decrease was found in six hippocampal subregions, including the bilateral presubiculum, the left parasubiculum, molecular layer of the hippocampus proper (molecular layer of the HP), and hippocampal amygdala transition area (HATA), and the right cornu ammonis subfield 1 (CA1) area, in older adults with cognitive frailty, while the proportion of brain parenchyma and total number of white matter fibers were lower than those in the healthy controls. Positive correlations were found between Wechsler’s Memory Quotient and the size of the left molecular layer of the HP and HATA and the right presubiculum. The sizes of the left presubiculum, molecular of the layer HP, and HATA and right CA1 and presubiculum were found to be positively correlated with MoCA score. The sizes of the left parasubiculum, molecular layer of the HP and HATA were found to be negatively correlated with the physical frailty index.ConclusionSignificant volume decrease occurs in hippocampal subregions of older adults with cognitive frailty, and these changes are correlated with cognitive impairment and physical frailty. Therefore, the atrophy of hippocampal subregions could participate in the pathological progression of cognitive frailty.

scholarly journals Deviations in Hippocampal Subregion Associated With Cognitive and Physical Frailty in Older Adults With Cognitive Frailty

2020 ◽  
Author(s):  
Mingyue Wan ◽  
Yu Ye ◽  
Huiying Lin ◽  
Ying Xu ◽  
Shengxiang Liang ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Molecular Layer ◽  
Heterogeneous Structure ◽  
Healthy Controls ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Significant Volume ◽  
The Right ◽  
Volume Decrease

Abstract Background The hippocampus is a complex, heterogeneous structure that is composed of widely different and interacting subregions. Atrophy of these subregions has been implicated in a variety of neurodegenerative diseases. Cognitive frailty is a kind of neurodegenerative disease with unclear neuropathological changes. The aim of this study was to explore the changes in hippocampal subregions in older adults with cognitive frailty and the relationship between subregions and cognitive decline as well as physical frailty.Methods Twenty-six older adults with cognitive frailty and 26 matched healthy controls were included in this study. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA) scale (Fuzhou version) and Wechsler's Memory Scale, while physical frailty was tested with the Chinese version of the Edmonton Frailty Scale (EFS) and grip strength. The volume of the hippocampal subregions was measured with structural brain magnetic resonance imaging. Partial correlation analysis was carried out between the volumes of hippocampal subregions and MoCA scores, Wechsler’s Memory Quotient and physical frailty indexes.Results A significant volume decrease was found in six hippocampal subregions, including the bilateral presubiculum, the left parasubiculum, molecular layer of the HP, and HATA, and the right CA1 area, in older adults with cognitive frailty (P<0.05/12), while the proportion of brain parenchyma and total number of white matter fibers were lower than those in the healthy controls (P<0.05). Positive correlations were found between Wechsler’s Memory Quotient and the size of the left molecular layer of the HP and HATA and the right presubiculum (P<0.05). The sizes of the left presubiculum, molecular of the layer HP, and HATA and right CA1 and presubiculum were found to be positively correlated with MoCA score (P<0.05). The sizes of the left parasubiculum, molecular layer of the HP and HATA were found to be negatively correlated with the physical frailty index (P<0.05).Conclusion Significant volume decrease occurs in hippocampal subregions of older adults with cognitive frailty, and these changes are correlated with cognitive decline and physical frailty. Therefore, the atrophy of hippocampal subregions could participate in the pathological progression of cognitive frailty.

scholarly journals Polypharmacy and lack of joy predict physical frailty among northern Japanese community-dwellers from the ORANGE cohort study

2020 ◽  
Author(s):  
Yu Kume ◽  
Tomoko Takahashi ◽  
Yuki Itakura ◽  
Sangyoon Lee ◽  
Hyuma Makizako ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Assessment Tool ◽  
Frailty Index ◽  
Limited Information ◽  
Physical Frailty ◽  
Cognitive Domains ◽  
Frailty Status ◽  
Critical Issues ◽  
Community Dwellers

Abstract Background: A gradually increasing prevalence of frailty is recognized in the super-aging society that Japan faces, and early detection and intervention of frailty in community-dwellers are critical issues to prevent frailty. Although previous studies have well documented the characteristics of physical disability, there is limited information on frail state differences among older adults in Japanese rural areas. The aim of this study was to clarify the association and predictors of frail status in northen Japan community-dwellers aged 65 or more.Methods: The investigation was conducted from 2018 to 2020. After obtaining informed consent from each participant, assessments and outcomes were evaluated according to the ORANGE protocol. Participants were recruited from Akita community-dwellers in northern Japan. We applied the frailty index of Gerontology - the Study of Geriatric Syndromes (NCGG-SGS) to classify frailty status, collecting data of demographics and psycho-social status using the Kihon checklist and cognitive domains including the National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT).Results: Our subjects included 313 older adults divided into 138 robust, 163 prefrail and 12 frail. For statistical analysis, physical frailty and cognitive decline were related, and polypharmacy and a lack of joy in daily life were the main predictors of frail status.Conclusions: Reducing medications and finding fun in your life are important to prevent frailty.

scholarly journals Cognitive Frailty and Its Long-Term Effect on Depression in an Older Population in Korea

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 442-442
Author(s):  
Yoonjung Ji ◽  
TaeWha Lee ◽  
Eunkyung Kim
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Group Analysis ◽  
Secondary Analysis ◽  
Epidemiological Studies ◽  
Physical Frailty ◽  
Older Population ◽  
Cognitive Frailty ◽  
The Relationship

Abstract Cognitive frailty is a condition where physical frailty and mild cognitive impairment (MCI) co-exist without dementia. It occurs in 1.8%-8.9% of the general older population, and older people with depression have a higher risk of frailty. However, the relationship between cognitive frailty and depression is still unclear. This study aimed to determine the relationship between cognitive frailty and depression of older adults by time using comparative group analysis. A secondary analysis was conducted using the Korean Longitudinal Study of Aging (KLoSA) dataset from 2010 to 2018. A sample was 981 older adults who were 65 years old and without dementia over residing in the community. Cognitive frailty was defined as having a mini-mental state examination score of 18-23 and 3 or more of the Fried frailty indexes. Generalized Estimating Equation model and chi-square test were employed. Of the 981 subjects, the cognitive frailty(CF) was 28.5%, followed by robust (37.7%), physical frailty (PF, 29.4%), mild cognitive impairment (MCI, 4.4%) at baseline. The group differences on depression measured by the Center for Epidemiological Studies Depression (CESD) were statistically significant in the PF (F=4.70, p&lt;.001) and the CF (F=4.95, p&lt;.001) group compared to the robust group. The time difference effect (F=.09, p=.05) and a group-by-time interaction effect were observed (p&lt;.001). This study confirmed that cognitive frailty is strongly associated with depression. Effective approaches to managing psychological wellbeing, including dementia, are essential for older adults with cognitive frailty.

Is Social Network a Protective Factor for Cognitive Impairment in US Chinese Older Adults? Findings from the PINE Study

Gerontology ◽  
2017 ◽  
Vol 64 (3) ◽  
pp. 246-256 ◽  
Author(s):  
Mengting Li ◽  
Xinqi Dong
Keyword(s):  
Older Adults ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Social Network ◽  
Cognitive Function ◽  
Protective Factor ◽  
Network Size ◽  
Chinese Older Adults ◽  
Cognitive Domains ◽  
Global Cognition

Background: Social network has been identified as a protective factor for cognitive impairment. However, the relationship between social network and global and subdomains of cognitive function remains unclear. Objective: This study aims to provide an analytic framework to examine quantity, composition, and quality of social network and investigate the association between social network, global cognition, and cognitive domains among US Chinese older adults. Methods: Data were derived from the Population Study of Chinese Elderly (PINE), a community-engaged, population-based epidemiological study of US Chinese older adults aged 60 and above in the greater Chicago area, with a sample size of 3,157. Social network was assessed by network size, volume of contact, proportion kin, proportion female, proportion co-resident, and emotional closeness. Cognitive function was evaluated by global cognition, episodic memory, executive function, working memory, and Chinese Mini-Mental State Examination (C-MMSE). Linear regression and quantile regression were performed. Results: Every 1-point increase in network size (b = 0.048, p < 0.001) and volume of contact (b = 0.049, p < 0.01) and every 1-point decrease in proportion kin (b = -0.240, p < 0.01) and proportion co-resident (b = -0.099, p < 0.05) were associated with higher level of global cognition. Similar trends were observed in specific cognitive domains, including episodic memory, working memory, executive function, and C-MMSE. However, emotional closeness was only significantly associated with C-MMSE (b = 0.076, p < 0.01). Social network has differential effects on female versus male older adults. Conclusion: This study found that social network dimensions have different relationships with global and domains of cognitive function. Quantitative and structural aspects of social network were essential to maintain an optimal level of cognitive function. Qualitative aspects of social network were protective factors for C-MMSE. It is necessary for public health practitioners to consider interventions that enhance different aspects of older adults' social network.

scholarly journals The Effect of Diabetes on the Cognitive Trajectory of Older Adults in Mexico and the United States

2020 ◽  
Author(s):  
Jaqueline C Avila ◽  
Silvia Mejia-Arangom ◽  
Daniel Jupiter ◽  
Brian Downer ◽  
Rebeca Wong
Keyword(s):  
United States ◽  
Older Adults ◽  
Linear Models ◽  
The United States ◽  
Mixed Effect ◽  
Cognitive Domains ◽  
Aging Study ◽  
Nationally Representative ◽  
The Impact ◽  
Over Time

Abstract Objectives To study the impact of diabetes on the long-term cognitive trajectories of older adults in 2 countries with different socioeconomic and health settings, and to determine whether this relationship differs by cognitive domains. This study uses Mexico and the United States to confirm if patterns hold in both populations, as these countries have similar diabetes prevalence but different socioeconomic conditions and diabetes-related mortality. Methods Two nationally representative cohorts of adults aged 50 years or older are used: the Mexican Health and Aging Study for Mexico and the Health and Retirement Study for the United States, with sample sizes of 18,810 and 26,244 individuals, respectively, followed up for a period of 14 years. The outcome is cognition measured as a total composite score and by domain (memory and nonmemory). Mixed-effect linear models are used to test the effect of diabetes on cognition at 65 years old and over time in each country. Results Diabetes is associated with lower cognition and nonmemory scores at baseline and over time in both countries. In Mexico, diabetes only predicts lower memory scores over time, whereas in the United States it only predicts lower memory scores at baseline. Women have higher total cognition and memory scores than men in both studies. The magnitude of the effect of diabetes on cognition is similar in both countries. Discussion Despite the overall lower cognition in Mexico and different socioeconomic characteristics, the impact of diabetes on cognitive decline and the main risk and protective factors for poor cognition are similar in both countries.

scholarly journals Heterogeneous Influence of Frailty Phenotypes in Age-Related Hearing Loss and Tinnitus in Chinese Older Adults: An Explorative Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Qingwei Ruan ◽  
Jie Chen ◽  
Ruxin Zhang ◽  
Weibin Zhang ◽  
Jian Ruan ◽  
...  
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Community Dwelling ◽  
Lower Probability ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Cognitive Frailty ◽  
Age Related

BackgroundFried physical frailty, with mobility frailty and non-motor frailty phenotypes, is a heterogeneous syndrome. The coexistence of the two phenotypes and cognitive impairment is referred to as cognitive frailty (CF). It remains unknown whether frailty phenotype has a different association with hearing loss (HL) and tinnitus.MethodsOf the 5,328 community-dwelling older adults, 429 participants aged ≥58 years were enrolled in the study. The participants were divided into robust, mobility, and non-mobility frailty, mobility and non-mobility CF (subdivided into reversible and potentially reversible CF, RCF, and PRCF), and cognitive decline [subdivided into mild cognitive impairment (MCI) and pre-MCI] groups. The severity and presentations of HL and/or tinnitus were used as dependent variables in the multivariate logistic or nominal regression analyses with forward elimination adjusted for frailty phenotype stratifications and other covariates.ResultsPatients with physical frailty (mobility frailty) or who are robust were found to have lower probability of developing severe HL and tinnitus, and presented HL and/or tinnitus than those with only cognitive decline, or CF. Patients with RCF and non-mobility RCF had higher probability with less HL and tinnitus, and the presentation of HL and/or tinnitus than those with PRCF and mobility RCF. Other confounders, age, cognitive and social function, cardiovascular disease, depression, and body mass index, independently mediated the severity of HL and tinnitus, and presented HL and/or tinnitus.ConclusionFrailty phenotypes have divergent association with HL and tinnitus. Further research is required to understand the differential mechanisms and the personalized intervention of HL and tinnitus.Clinical Trial RegistrationClinicalTrials.gov identifier, NCT2017K020.

scholarly journals Physical Frailty and Cognitive Functioning in Korea Rural Community-Dwelling Older Adults

2018 ◽  
Vol 7 (11) ◽  
pp. 405 ◽  
Author(s):  
Dong Yoon ◽  
Su Hwang ◽  
Dong Lee ◽  
Chung Lee ◽  
Wook Song
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Muscle Strength ◽  
Cognitive Functioning ◽  
Physical Function ◽  
Rural Community ◽  
Community Dwelling ◽  
Physical Frailty ◽  
Cognitive Domains ◽  
Community Dwelling Older Adults

Cognitive frailty is a heterogeneous clinical manifestation characterized by the simultaneous presence of physical frailty and cognitive impairment. The objective of this study was to investigate the association between physical frailty and cognitive function in rural community-dwelling older Korean adults, taking four cognitive domains into account. We carried out a cross-sectional population-based study which enrolled 104 community-dwelling elderly. Physical frailty phenotype, as well as its individual criteria, were used. Cognitive functioning was examined in the four domains of memory, processing speed, cognitive flexibility, and working memory. Demographic data, lipid profile, muscle strength, physical function, and 25-hydroxyvitamin D (25[OH]D) concentration collected from questionnaire interviews and assessments were included. Of the 104 older adults (77% female), 24.3% were classified as robust, 49.6% as prefrail, and 16.5% as frail. Linear regression analyses showed that the severity of frailty index was associated with four cognitive domains Muscle strength (i.e., Grip strength, Knee extensor and flexor), physical function (i.e., SPPB and Gait speed), and 25[OH]D were associated with poorer cognitive function. Within our population of Korean rural community-dwelling older adults, physical frailty status, muscle strength, physical functions, and biochemical measurements were associated with poorer cognitive function. Synchronicity of physical frailty and cognitive dysfunction may contribute to the negative health-related effects associated with aging.

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