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 Cognitive function and amyloid marker in frail older adults: The COGFRAIL Cohort Study

2020 ◽  
pp. 1-8
Author(s):  
S. Sourdet ◽  
G. Soriano ◽  
J. Delrieu ◽  
Z. Steinmeyer ◽  
S. Guyonnet ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Composition ◽  
Cognitive Impairment ◽  
Amyloid Β ◽  
Amyloid Pet ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Frail Older Adults ◽  
Amyloid Pathology ◽  
Cerebral Amyloid

Background: Frailty and cognitive impairment are common manifestations of the ageing process and are closely related. But the mechanisms linking aging, physical frailty, and cognitive disorders, are complex and remain unclear. Objectives: We aim to explore the role of cerebral amyloid pathology, but also a range of nutritional, physical, biological or brain-aging marker in the development of cognitive frailty. Method: COGFRAIL study is a monocentric prospective study of frail older patients with an objective cognitive impairment (Clinical Dementia Rating Scale global score at 0.5 or 1). Three-hundred-and-twenty-one patients are followed up every 6 months, for 2 years. Clinical assessment at baseline and during follow-up included frailty, physical, mood, sensory, nutritional, and cognitive assessment (with a set of neuropsychological tests). Cerebral amyloid pathology is measured by amyloid Positron Emission Tomography (PET) or amyloid-β-1-42 level in cerebrospinal fluid. Brain magnetic resonance imaging, measurement of body composition using Dual X Ray Absorptiometry and blood sampling are performed. The main outcome of the study is to assess the prevalence of positive cerebral amyloid status according to amyloid PET or amyloid-β-1-42 level CSF. Secondary outcomes included biological, nutritional, MRI imaging, cognitive, clinical, physical and body composition markers to better understand the mechanisms of cognitive frailty. Perspective: COGFRAIL study will give the opportunity to better understand the link between Gerosciences, frailty, cognitive impairment, and Alzheimer’s disease, and to better characterize the physical and cognitive trajectories of frail older adults according to their amyloid status. Understanding the relationship between physical frailty and cognitive impairment is a prerequisite for the development of new interventions that could prevent and treat both conditions.

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 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.

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 Cognitive frailty in relation to adverse health outcomes independent of multimorbidity in Chinese older adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 908-909
Author(s):  
Zuyun Liu ◽  
Chen Chen ◽  
Juyoung Park ◽  
Chenkai Wu ◽  
Qian-Li Xue ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Health Outcomes ◽  
Healthy Aging ◽  
Physical Frailty ◽  
International Consensus ◽  
Cognitive Frailty ◽  
Chinese Older Adults ◽  
Adverse Health ◽  
Adverse Health Outcomes

Abstract Cognitive frailty was proposed in 2013 by an (I.A.N.A./I.A.G.G.) international consensus group; however, little is known about its status and associations with adverse health outcomes in China. The objectives of this study were to evaluate: 1) the associations of cognitive frailty with various health outcomes including disability, hospitalization, and death; 2) whether the associations differed by multimorbidity in Chinese older adults. We included 5113 Chinese older adults (aged 60+ years) who had baseline (2011 wave) cognition and physical frailty assessments and follow-up for 4 years from the China Health and Retirement Longitudinal Study. We found that about 16.0% had cognitive impairment; 6.7% had physical frailty; and 1.6% met criteria for cognitive frailty (having both cognitive impairment and physical frailty). Both cognitive impairment (odds ratios (ORs) range: 1.41 to 2.11) and physical frailty (ORs range: 1.51 to 2.43) were independently associated with basic activities of daily living (BADL), instrumental ADL (IADL), mobility disability, hospitalization, and death among participants without that corresponding outcome at baseline, even after accounting for covariates. Relative to participants who had normal cognition and were nonfrail, those with cognitive frailty had the highest risk for IADL disability (OR=3.40, 95% CI, 1.23–9.40) and death (OR=3.89, 95% CI, 2.25–6.47). We did not find significant interaction effects between cognitive frailty and multimorbidity (P for interactions&gt;0.05). Overall, cognitive frailty was associated with disability and death, independent of multimorbidity. This highlights the importance of assessing cognitive frailty in the community to promote primary and secondary preventions for healthy aging.

scholarly journals Cognitive Frailty Predicts Incident Dementia among Community-Dwelling Older People

2018 ◽  
Vol 7 (9) ◽  
pp. 250 ◽  
Author(s):  
Hiroyuki Shimada ◽  
Takehiko Doi ◽  
Sangyoon Lee ◽  
Hyuma Makizako ◽  
Liang-Kung Chen ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Significant Risk ◽  
Word List ◽  
Community Dwelling ◽  
Prevalence Rates ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Primary Screening ◽  
Incident Dementia

Cognitive frailty, defined as the presence of both frailty and cognitive impairment, is a risk factor for adverse events in older adults. However, prevalence rates of cognitive frailty are low (1.1–2.5%), so primary screening is unsuitable in community settings. The aim of the study was to examine whether a new definition of cognitive frailty, which was developed for primary screening, is useful to predict incident dementia in community-dwelling older adults. A total of 4570 older adults participated in the study (2326 women; average age, 71.9 ± 5.5 years). We defined physical frailty as the presence of ≥1 of the following symptoms: slow walking speed and muscle weakness. Cognitive impairment was defined as ≥1 symptom of cognitive impairment, indicated by an age- and education-adjusted score that was ≥1.5 standard deviations below the reference threshold in word list memory, attention, executive function, and processing speed tests. Cognitive frailty was defined as comorbid physical frailty and cognitive impairment. The incidence of dementia was determined using data collected by the Japanese Health Insurance System over 36 months. The prevalence rates of physical frailty, cognitive impairment, and cognitive frailty were 17.5%, 15.3%, and 9.8%, respectively. Cognitive impairment (hazard ratio [HR]: 2.06, 95% confidence interval [95% CI]: 1.41–3.02) and cognitive frailty (HR: 3.43, 95% CI: 2.37–4.97) were found to be significant risk factors for dementia. However, the association between dementia and physical frailty was not significant (HR: 1.13, 95% CI: 0.76–1.69). Individuals with comorbid physical frailty and cognitive impairment could have a higher risk of dementia than healthy older adults or older adults with either physical frailty or cognitive impairment alone.

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

2020 ◽  
Vol 17 (5) ◽  
pp. 1547 ◽  
Author(s):  
Nurul Fatin Malek Rivan ◽  
Suzana Shahar ◽  
Nor Fadilah Rajab ◽  
Devinder Kaur Ajit Singh ◽  
Normah Che Din ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Longitudinal Study ◽  
Functional Mobility ◽  
Physical Frailty ◽  
Community Based ◽  
Timed Up And Go ◽  
Cognitive Frailty ◽  
Increased Risk ◽  
Study Results

(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 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.

scholarly journals 112 Cognitive Frailty, Physical Frailty and Loneliness Predicts the Incidence of Falls among Community-Dwelling Older Adults

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv18-iv27
Author(s):  
Nurul Fatin Malek Rivan ◽  
Suzana Shahar ◽  
Nor Fadilah Rajab ◽  
Devinder Kaur Ajit Singh ◽  
Normah Che Din ◽  
...  
Keyword(s):  
Older Adults ◽  
Univariate Analysis ◽  
Predictive Ability ◽  
Binary Logistic Regression ◽  
High Risk Group ◽  
Community Dwelling ◽  
Grand Challenge ◽  
Physical Frailty ◽  
Cognitive Frailty ◽  
Community Dwelling Older Adults

Abstract Background Although frailty is a well-known risk factor for falls, the concomitant effects of physical frailty and cognitive impairments or known as cognitive frailty (CF), in predicting the incidence falls is not established. Methods In a prospective cohort study, we examined the predictive ability of CF towards the incidence of falls among older adults from Malaysian Towards Useful Aging (TUA) study. A total of 400 participants aged &gt; 60 years were successfully followed up at five years. Participants were interviewed on their sociodemographic data, medical and falls history. Assessments to examine cognitive function, physical functional status, psychosocial and dietary intake were conducted. Univariate analysis was performed for every variable, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls. Results After adjusting for the covariates, CF (Odd Ratio (OR) = 2.976, 95% Confidence Interval (CI): 1.776-4.987, p&lt;0.05), physical frailty (OR = 2.882, 95% CI: 1.187-6.999, p&lt;0.05), women (OR = 2.229, 95% CI: 1.362-3.648, p&lt;0.05), and loneliness (OR = 1.329, 95% CI: 1.028-1.718, p&lt;0.05) were the significant predictors for the incidence of falls. Conclusion Both cognitive and physical frailty were significant predictors of future falls among community-dwelling older adults. It is important to provide an effective intervention to prevent falls in this high-risk group of older adults. This study was funded by the Long-term Research Grant Scheme (LGRS) provided by the Ministry of Education Malaysia (LRGS/BU/2012/UKM-UKM/K/01) and Grand Challenge Grant funded by the National University of Malaysia (DCP-2017-002/1).

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.

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