Frailty and cognitive performance of elderly in the context of social vulnerability

Jesus, Isabela Thaís Machado de; Orlando, Fabiana de Sousa; Zazzetta, Marisa Silvana

doi:10.1590/1980-57642018dn12-020010

Cited by 23 publications

(19 citation statements)

References 39 publications

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“…This study demonstrates that, compared to non-frail older persons, those with frailty were more likely to be 80 years old or more, with a predominance of females, those living in nursing home, and those with low BMI, in accordance with other studies of frail elderly populations [ 19 , 20 ]. In addition, our findings indicate that frailty is mostly associated with cognitive impairment, risk of depression, altered nutritional status, and a decline in functional domains (ADL and TUG).…”

Section: Discussionsupporting

confidence: 91%

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

et al. 2020

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The present study was undertaken to evaluate serum levels of pro-inflammatory cytokines in Tunisian older adults and to examine the relationships between inflammatory marker levels, geriatric, and biochemical parameters. A cross-sectional study was conducted in a population of Tunisian older adults (N = 141, aged 65 and over). Patients were recruited from the Department of Internal Medicine, Fattouma Bourguiba University Hospital (Monastir, Tunisia) and from a nursing home (Sousse, Tunisia). Comprehensive geriatric assessment, history taking and examination including functional and nutritional assessment were done for each participant. Enzyme-linked immunosorbent assay (ELISA) test was used to measure serum cytokine (TNF-α, IL-8, IL-6) levels. The modified Short Emergency Geriatric Assessment score (SEGAm) were used to classify patients as 51 very-frail, 40 frail, and 50 non-frail. The age of the participants (80 men, 61 women) ranged from 65 to 97 years. Serum levels of TNF-α, IL-8 and C-reactive protein (CRP) were significantly higher in very-frail participants compared to frail and non-frail ones. However, no significant differences in IL-6 levels were detected among frailty groups. After adjustment for age, CRP and IL-8 levels remained significantly associated with frailty. Analysis of the receiver operating characteristic (ROC) curve corresponding to IL-8 showed an area under the curve of 0.7 (p = 0.003; 95% CI [0.58–0.81]) and a predictive threshold of 5.27 pg/ml. Positive correlations were found between frailty score, IL-6, and IL-8 levels. In addition, a significant positive correlation was observed between IL-8 levels and Timed Up and Go test results. However, a negative correlation was observed between Mini Nutritional Assessment Short-Form score, IL-6 and CRP levels, as well as between Activities of Daily Living score and serum levels of TNF-α, IL-6, and CRP. In conclusion, the key findings of this study collectively support a role of pro-inflammatory cytokines, TNF-α, CRP, and especially IL-8 in the development of frailty in older adults.

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Section: Discussionsupporting

confidence: 91%

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

et al. 2020

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“…Studies involving the Brazilian population of older adults report that women account for the majority of the samples, 6,24 which is likely due to the greater longevity of women compared to men, leading to a larger contingent of women aged 60 years or older. 25 This phenomenon is directly reflected in scientific studies involving samples recruited from the community.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 A vulnerable individual is less likely to cope with stressful events, 4 which can lead to adverse health outcomes, such as functional decline, 5 and the aggravation of preexisting conditions, such as cognitive decline and physical frailty. 6 A slight decrease in cognitive function is expected during the aging process.…”

Section: Introductionmentioning

confidence: 99%

Cumulative effects of cognitive impairment and frailty on functional decline, falls and hospitalization: A four-year follow-up study with older adults

Brígola

Ottaviani

Alexandre

et al. 2020

Archives of Gerontology and Geriatrics

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Cumulative effects of cognitive impairment and frailty on functional decline, falls and hospitalization: a four-year follow-up study with older adults OBJECTIVE: Evaluate the cumulative effects of cognitive impairment and frailty on functional decline, falls and hospitalization in older adults over a four-year period. METHOD: Four hundred five older adults (60-95 years; mean age: 70.62 ± 7.12 years), 57% female. The frailty evaluation was performed using the clinical criteria of the Cardiovascular Health Study (CHS): weight loss, fatigue, weakness, slowness and low physical activity. Cognitive impairment was defined by cutoff scores of the Mini Mental State Examination (MMSE) based on schooling. Follow-upfunctional decline was assessed using the Lawton&Brody scale of instrumental activities of daily living (IADL). An investigation was also performed of the occurrence of falls and admissions to the hospital in the previous twelve months. RESULTS: Cognitive impairment was associated with admissions to the hospital and declines in the IADL category of using a telephone. Frailty was associated with admissions to hospital. Cumulative effects were observed for hospitalization and the decline in using the telephone and shopping. Frailty and cognitive impairment increased the risk of being admitted to hospital by 557% and increased the risk of a decline in using the phone by 262% and shopping by 208%. No conditions were associated to risk of falls. CONCLUSION: The combination of the MMSE and the CHS criteria was adequate for measuring the cumulative effects of cognitive impairment and frailty. Shared physiological mechanisms may explain the relation between cognitive impairment and frailty, but further investigations are needed in Brazil and other low/middle-income countries.

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“… 14 , 15 Frailty is a dynamic and multidimensional syndrome, that affects human functioning and is caused by a range of variables that increase the risk for dependency, institutionalization and death in old age. 16 , 17 Older adults with low education in Europe also seem to have a three times higher risk of being categorized as frail, as opposed to older adults with higher levels of education. 18 A Dutch study indicated that mature and older people who have completed higher education had consistently less overall frailty than people with primary or secondary education.…”

mentioning

confidence: 99%

Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults

Brígola

Alexandre

Inouye

et al. 2019

Dement. neuropsychol.

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ABSTRACT. Limited formal education is still common in ageing populations. Although limited formal education seems to be independently and negatively associated with cognition, functional abilities and frailty in ageing, no studies have examined whether the gradient of limited formal education has an impact on health in later life. Objective: to examine the relationship of limited formal education with cognitive status, functional abilities, and frailty status. Methods: a cross-sectional study was conducted involving 540 older adults stratified into groups: no formal education, 12-24 months of education, and 25-48 months of education. Cognitive screening (MMSE), functional abilities (Lawton Index), and frailty (CHS criteria) were measured. Regression analyses were performed. Results: 27% had no formal education, 21% had 12-24 months of formal education, and 55% had 25-48 months of formal education. Limited formal education has a clear gradient of negative impact: No formal education was associated with scoring below MMSE cut-off scores (OR = 7.9), being totally/partially dependent for IADLs (OR = 2.5) and frail (OR = 2.0). Having 12-24 months of education was associated with scoring below MMSE cut-off scores (OR = 5.2) and with being frail (OR = 2.0). The No formal education group was 10.1 times more likely to have worse cognitive scores, worse functional abilities and frailty/pre-frailty status concomitantly (CCoFF), while older adults who had 12-24 months of education had a 4.6 times greater chance of having CCoFF. Conclusion: limited education had a gradient association with cognitive performance, functional disability and frailty. These findings clearly emphasize the importance of prevention through education from childhood to older age.

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Frailty and cognitive performance of elderly in the context of social vulnerability

Cited by 23 publications

References 39 publications

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

Evaluation of pro-inflammatory cytokines in frail Tunisian older adults

Cumulative effects of cognitive impairment and frailty on functional decline, falls and hospitalization: A four-year follow-up study with older adults

Limited formal education is strongly associated with lower cognitive status, functional disability and frailty status in older adults

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