Calf Circumference as a Screening Tool for Cognitive Frailty in Community-Dwelling Older Adults: The Korean Frailty and Aging Cohort Study (KFACS)

Abstract

The aim of this study was to examine calf circumference in relation to cognitive frailty in community-dwelling older adults. Cross-sectional analysis was performed on the first-year baseline data of 1559 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. The final analysis included 1221 adults who were non-dependent in terms of instrumental activities of daily living, who underwent frailty and cognitive function assessments. Physical frailty was defined using the Fried Frailty Index. Cognitive impairment was defined as a score 1.5 standard deviations below the age-, sex- and education-matched norms on any of four cognitive-function tests. The prevalence of cognitive frailty was 2.8% for men and 3.8% for women. After adjusting for potential confounders, in comparison to the “physically robust without cognitive impairment” group, the estimates of increased odds ratios (ORs) for low calf circumference (<32 cm) were much greater in the prefrail with cognitive impairment (OR 4.62, 95% confidence interval (CI): 2.02–10.61) and frail with cognitive impairment (OR 10.94, 95% CI: 2.87–41.68) groups in men but not in women. Low calf circumference was strongly related to cognitive frailty in men only, suggesting calf circumference can be used as an indicator of these outcomes.

Sarcopenia Is Associated with Cognitive Impairment Mainly Due to Slow Gait Speed: Results from the Korean Frailty and Aging Cohort Study (KFACS)

“…Cognitive impairment was defined as 1.5 SDs below the age-, sex- and education-matched Korean norms on the following cognitive function tests [22,23,24]: processing speed (trail making test A), executive function (Frontal Assessment Battery), verbal episodic memory (word list recall test), and working memory (digit span backward) [26,27]. Generally, neuropsychological tests consider values 1.5 SDs below those of an age- and education-matched control group [28].…”

Sarcopenia is Associated Cognitive Impairment Mainly Due to Slow Gait Speed: Results from the Korean Frailty and Aging Cohort Study (KFACS)

“…The global cognitive dysfunction was defined as 1.5 standard deviations (SDs) below the age-, sex-, and education-specific norms of the Korean version of the Mini-Mental State Examination (MMSE-KC). Cognitive impairment was defined as 1.5 SDs below the age-, sex-and education-matched Korean norms on the following cognitive function tests [22][23][24]: processing speed (trail making test A), executive function (Frontal Assessment Battery), verbal episodic memory (word list recall test), and working memory (digit span backward) [26,27]. Generally, neuropsychological tests consider values 1.5 SDs below those of an age-and education-matched control group [28].…”

Korean frailty and aging cohort study (KFACS): cohort profile

“…The prevalence of frailty was reported to increase with a daily sodium intake of>3575 mg 39. The self-administered health assessment tool, the EQ-VAS, was deemed appropriate as a frailty screening tool,40 and low calf circumference (<32 cm) was shown to be strongly related to cognitive frailty in men 41…”