Frailty, cognitive impairment and mortality among the oldest old

Jacobs, Jeremy M.; Cohen, Aaron M.; Ein-Mor, Eliana; Maaravi, Yoram; Stessman, Jochanan

doi:10.1007/s12603-011-0096-3

Cited by 118 publications

(105 citation statements)

References 29 publications

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“…The risk of frail individuals exhibiting a decline in cognitive function in a 12-month period, as evaluated by the MMSE, was approximately fivefold greater in comparison to non-frail individuals. Previous studies with a longer follow-up period also report an association between frailty and cognitive decline measured by the MMSE 4,6,8 .…”

Section: Discussionmentioning

confidence: 79%

“…The association between frailty and cognitive impairment is widely discussed in the literature [3][4][5][6][7] . While studies have shown that frailty may be a predictor of mild cognitive impairment, dementia and cognitive decline, there seems to be a biological association between the onset of cognitive decline and frailty [3][4][5][6][7] .…”

Section: Discussionmentioning

confidence: 99%

“…Frailty is generally associated with an increased risk of functional decline, institutionalization, hospitalization, and death 1-3 and has therefore been described as an important clinical and public health problem that merits further study 1 .Recent studies have identified an association between frailty and subsequent cognitive decline in 3-and 12-year cohorts 4,[6][7][8] . Moreover, associations have been found between frailty and an increased incidence of mild cognitive impairment 7 and Alzheimer's diease 6 .…”

mentioning

confidence: 99%

“…Recent studies have identified an association between frailty and subsequent cognitive decline in 3-and 12-year cohorts 4,[6][7][8] . Moreover, associations have been found between frailty and an increased incidence of mild cognitive impairment 7 and Alzheimer's diease 6 .…”

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confidence: 99%

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Frailty and cognitive impairment among community-dwelling elderly

Alencar¹,

Dias²,

Figueiredo³

et al. 2013

Arq. Neuro-Psiquiatr.

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Frailty is an important geriatric syndrome that results from a reduction in the reserves of multiple systems, leading to a state of increased vulnerability to stressors 1,2 . Frailty is generally associated with an increased risk of functional decline, institutionalization, hospitalization, and death 1-3 and has therefore been described as an important clinical and public health problem that merits further study 1 .Recent studies have identified an association between frailty and subsequent cognitive decline in 3-and 12-year cohorts 4,[6][7][8] . Moreover, associations have been found between frailty and an increased incidence of mild cognitive impairment 7 and Alzheimer's diease 6 . In a study involving frail older adults with and without cognitive impairment, Ávila-Funes et al. 5 report that cognitive impairment increases the predictive validity of frailty for the occurrence of adverse outcomes in a four-year period.Longitudinal studies report that the progression rate of cognitive impairment among older adults ranges from 1 to 2% a year 9 . Moreover, older adults with cognitive impairment progress to more severe stages on an annual basis and the conversion rate to dementia can reach 10 to 30% a year 10,11 . However, there is little knowledge on the factors related to progressive cognitive impairment within a one-year period and whether this progression is associated with frailty. Thus, gaining a better understanding of the association between frailty and cognitive impairment within a short period of time may assist in establishing strategies aimed at prevention and treatment.Study carried out at Universidade Federal de Minas Gerais (UFMG), Belo Horizonte MG, Brazil. AbstrActThe aim was to evaluate associations between frailty status and cognitive decline and the incidence of cognitive impairment over 12-month period. Two hundred seven older adults were assessed. Frailty was defined as having at least three of the following criteria: weight loss, weakness, exhaustion, slowness, and low level of activity. Cognitive decline was assessed using the Mini Mental State Examination (MMSE) and Clinical Dementia Rating Scale (CDR). Relative risk (RR) was calculated with a 95% confidence interval (CI). Frailty was associated with subsequent cognitive decline in 12-month when assessed using the MMSE (p=0.005; RR=4.6; 95%CI 1.93-11.2). No association was found between frailty and cognitive decline measured by the CDR (p=0.393; RR=2.1; 95%CI 0.68-6.7) or between frailty and the incidence of cognitive impairment (p=0.675; RR=1.2; 95%CI 0.18-8.3). These findings reveal an association between frailty and subsequent cognitive decline when measured by the MMSE, even within a short period of time.Key words: aged, frail elderly dementia.resumo O objetivo foi avaliar a associação entre fragilidade e o declínio cognitivo e a incidência de alteração cognitiva, em 12 meses. Foram avaliados 207 idosos. Fragilidade foi definida como ter pelo menos três dos critérios: perda de peso, fraqueza, exaustão, lentidão e baixo nível de atividad...

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Frailty and cognitive impairment among community-dwelling elderly

Alencar¹,

Dias²,

Figueiredo³

et al. 2013

Arq. Neuro-Psiquiatr.

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“…There is increasing evidence that psychological and social problems can accelerate the development of disability, hospitalization, nursing home placement and death (14)(15)(16)(17)(18)(19)(20). In some cases the reasons for the synergistic effect are obvious while in others they are more complex and may depend on similar pathophysiological processes accelerating both problems (1,21).…”

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confidence: 99%

Frailty and cognition: Linking two common syndromes in older persons

Malmstrom

Morley

2013

The Journal of nutrition, health and aging

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Cognitive frailty as a predictor of adverse outcomes among older adults: A systematic review and meta‐analysis

Huang

Xue

et al. 2020

Brain and Behavior

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Objective A systematic review and meta‐analysis basing on the prospective cohort studies were conducted to explore the risk of all‐cause mortality and dementia in cognitively frail older adults compared to robust older adults and to determine whether it was a predictor of adverse outcomes. Methods Pubmed, Web of Science, The Cochrane Library, EMBASE, and CINAHL databases were searched to retrieve studies on adverse outcomes of cognitive frailty. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Stata 15.0 Software was used to perform the meta‐analysis. The all‐cause mortality and dementia were observed to be the primary outcomes, while the other data were considered as the secondary outcome. Results A total of 14 studies were included in qualitative analysis and 12 studies were included in the meta‐analysis, with low risk of bias and moderate to good methodological quality. The results showed that cognitive frailty in older people had a higher risk of all‐cause mortality [HR = 1.93, 95%CI (1.67, 2.23), p < .001] and dementia [HR = 3.66, 95%CI (2.86, 4.70) as compared with robust. The subgroup analysis showed that the assessment tools were the main source of heterogeneity. Conclusion In older adults living in communities, the cognitive frailty was found to be a significant predictor of all‐cause mortality and dementia. Nonetheless, cognitive frailty was found to be a better predictor of all‐cause mortality and dementia than just frailty.

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Frailty, cognitive impairment and mortality among the oldest old

Abstract: Among the oldest old, frailty status was significantly associated with cognitive impairment; after adjustment, frailty alone was predictive of subsequent mortality.

Cited by 118 publications

References 29 publications

Frailty and cognitive impairment among community-dwelling elderly

Frailty and cognitive impairment among community-dwelling elderly

Frailty and cognition: Linking two common syndromes in older persons

Cognitive frailty as a predictor of adverse outcomes among older adults: A systematic review and meta‐analysis

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