Abstract:The frailty syndrome has recently attracted attention of the scientific community and public health organizations as precursor and contributor of age-related conditions (particularly disability) in older persons. In parallel, dementia and cognitive disorders also represent major healthcare and social priorities. Although physical frailty and cognitive impairment have shown to be related in epidemiological studies, their pathophysiological mechanisms have been usually studied separately. An International Consensus Group on "Cognitive Specific aim of this approach was to facilitate the design of future personalized preventive interventions in older persons. Finally, the Group discussed the use of multidomain interventions focused on the physical, nutritional, cognitive and psychological domains for improving the well-being and quality of life in the elderly. The consensus panel proposed the identification of the so-called "cognitive frailty" as an heterogeneous clinical manifestation characterized by the simultaneous presence of both physical frailty and cognitive impairment. In particular, the key factors defining such a condition include: 1) presence of physical frailty and cognitive impairment (CDR=0.5); and 2) exclusion of concurrent AD dementia or other dementias. Under different circumstances, cognitive frailty may represent a precursor of neurodegenerative processes. A potential for reversibility may also characterize this entity. A psychological component of the condition is evident and concurs at increasing the vulnerability of the individual to stressors.

PROVENCHER, VÉ RONIQUE, VICKY DRAPEAU, ANGELO TREMBLAY, JEAN-PIERRE DESPRÉ S, AND SIMONE LEMIEUX. Eating behaviors and indexes of body composition in men and women from the Québec Family Study. Obes Res. 2003;11:783-792. Objective: To put into relationship the dietary and anthropometric profile of men and women with their eating behaviors (cognitive dietary restraint, disinhibition, and susceptibility to hunger) and to assess whether gender and obesity status influence these associations. Research Methods and Procedures: Anthropometric measurements (including visceral adipose tissue accumulation), dietary profile (3-day food record), and eating behaviors (Three-Factor Eating Questionnaire) were determined in a sample of 244 men and 352 women. Results: Women had significantly higher cognitive dietary restraint and disinhibition scores than men (p Ͻ 0.0001). In both genders, scores for disinhibition and susceptibility to hunger, but not for cognitive dietary restraint, were higher in obese subjects than in overweight and nonobese subjects (p Ͻ 0.05). Positive correlations were observed between rigid restraint and most of the anthropometric variables studied (0.12 Յ r Յ 0.16). Moreover, in women, flexible restraint was negatively associated with body fat and waist circumference (r ϭ Ϫ0.11). Cognitive dietary restraint and rigid restraint were positively related to BMI among nonobese women (0.19 Յ r Յ 0.20), whereas in obese men, cognitive dietary restraint and flexible restraint tended to be negatively correlated with BMI (Ϫ0.20 Յ r Յ Ϫ0.22; p ϭ 0.10). Discussion: Gender could mediate associations observed between eating behaviors and anthropometric profile. It was also found that disinhibition and susceptibility to hunger are positively associated with the level of obesity. On the other hand, cognitive dietary restraint is not consistently related to body weight and adiposity, whereas rigid and flexible restraint are oppositely associated to obesity status, which suggests that it is important to differentiate the subscales of cognitive dietary restraint. Finally, counseling aimed at coping with disinhibition and susceptibility to hunger could be of benefit for the long-term treatment of obesity.

1The main aim of this study was to investigate the effects of food-related beliefs 2 about the healthiness of foods, restrained eating, and weight salience on actual food intake 3 during an ad libitum snack. In a 2 (healthy vs. unhealthy) by 2 (restrained vs. unrestrained 4 eaters) by 2 (weight salient vs. not salient) factorial design, 99 female undergraduate 5 students were invited to taste and rate oatmeal-raisin cookies. Dietary restraint and weight 6 salience did not influence snack intake, but participants ate about 35% more when the 7 snack was regarded as healthy than when it was seen as unhealthy. Ratings of the snack 8 food's "healthiness," "capacity to affect weight" and "appropriateness in a healthy menu" 9 also indicated that the "healthy" manipulation was effective. In addition, the "weight salience" manipulation appears to influence perceptions about food differently in restrained 11 versus unrestrained eaters, in that restrained eaters rated the snack food more negatively 12 than unrestrained eaters did when they received weight feedback before eating. Beliefs 13 about the healthiness of foods may thus be of great relevance to both food intake and 14 weight gain.

OBJECTIVE: This study was performed to examine changes in eating behaviors as assessed by the three-factor eating questionnaire (TFEQ) and to quantify the potential associations between these eating behaviors and body weight changes in a 6-follow-up study. DESIGN AND SUBJECTS: Prospective study performed in men and women who were tested twice (Visit 1 ¼ 1989-1995 and Visit 2 ¼ 6 y later) in the Québec Family Study (QFS). RESULTS: Women were more restrained and less hungry than men. To reduce food intake, women relied more on strategic dieting behavior and avoided more fattening food. However, they had higher emotional and situational susceptibility to eat than men. Significant decreases in the disinhibition score were noted over time in women (Po0.01), which resulted from a decrease in habitual susceptibility behavior to increase food intake. In men, we observed an increase in the avoidance of fattening food (Po0.05). In both genders, we found that the 6-y change in restraint behavior was negatively correlated with body weight changes (Po0.05). In women, a high restraint behavior seems to promote weight gain, whereas in men, it is associated with the opposite trend. CONCLUSION: These results suggest that variables reflecting some eating behaviors are associated with body weight changes in a free-living context. However, these behaviors are expressed differently between men and women. These behaviors should be considered in clinical interventions for individuals seeking a better body weight control.