Mini-Mental State Examination performance in frail, pre-frail, and non-frail community dwelling older adults in Ermelino Matarazzo, São Paulo, Brazil

Macuco, Cláudia Rodrigues Monteiro; Batistoni, Samila Sathler Tavares; Lopes, Andréa Cintra; Cachioni, Meire; Falcão, Deusivânia Vieira da Silva; Néri, Anita Liberalesso; Yassuda, Mônica Sanches

doi:10.1017/s1041610212000907

Cited by 93 publications

(99 citation statements)

References 30 publications

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“…The results of this study confirm the association between frailty and poor cognitive performance found in other studies 4,13,20 and gives a result previously unreported in the literature on the topic: the role of age as an effect modifier in this association.…”

Section: Discussionsupporting

confidence: 91%

“…The first study did not investigate the role of age and schooling in the association in question. In a second study with the same sample, Macuco et al 13 showed that the MMSE score was influenced by age, education, household income and being frail. Frail older elderly individuals performed significantly worse in the MMSE.…”

Section: Yassuda Et Almentioning

confidence: 94%

“…13 None of these studies assessed the role played by age an effect modifier on the association between frailty and poor cognitive performance. This variable was tested only as a confounding factor with regards frailty and cognition.…”

mentioning

confidence: 99%

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Desempenho cognitivo e fragilidade em idosos clientes de operadora de saúde

et al. 2013

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OBJECTIVE:To investigate the association between frailty syndrome and cognitive performance in the older adults and the effect of schooling and age on this association. METHODS:Data on frailty in older adults from Phase 1 of the FIBRA-RJ Study were analyzed, relating to 737 customers of a private health care provider, aged 65 and over, living in Rio de Janeiro, Southeastern Brazil, between January 2009 and January 2010. Data on socioeconomic and demographic characteristics, medical conditions and functional capacity were collected. Cognitive performance was assessed using the Mini-Mental State Examination (MMSE). Individuals who exhibited three or more of the following features were considered to be frail: unintentional weight loss (≥ 4.5 kg in the last year); feeling self-reported exhaustion, low grip strength, low physical activity level and slowness. The association between frailty and cognitive performance was evaluated using multivariate logistic regression, with adjustment for medical conditions, activities of daily living and socioeconomic variables. We evaluated the age and schooling as possible effect modifiers in this association. RESULTS:The frail subjects had a higher prevalence of low cognitive performance, compared to not frail or pre-frail, in the three age groups studied (65-74; 75-84; ≥ 85 years), p < 0.001. After adjustment, the association between frailty and cognitive performance was found among older adults individuals aged 75 and older, with an OR adj = 2.78 (95%CI 1.23;6.27) for those aged 75 to 84 and OR adj = 15.62 (95%CI 2.20;110.99) for 85 and older. The age variable was an effect modifier in the association between frailty and cognitive performance, χ² (5) = 806.97, p < 0.0001; the same was not the case with schooling. CONCLUSIONS:Frailty syndrome is associated with cognitive performance in the aging. Age proved to be an effect modifier in this association. The oldest patients showed a more significant association between the two phenomena.

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Section: Discussionsupporting

confidence: 91%

Section: Yassuda Et Almentioning

confidence: 94%

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Desempenho cognitivo e fragilidade em idosos clientes de operadora de saúde

et al. 2013

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“…A cross-sectional correlation between frailty and cognitive impairment has previously been reported [5] and longitudinal studies have also reported frailty as a predictor of subsequent cognitive impairment. More specifically, the study by Avila-Funes et al [23] showed that frailty, defined according to Fried's criteria, is a major risk factor for incident vascular dementia.…”

Section: Discussionmentioning

confidence: 89%

Association between Frailty and Dementia: A Population-Based Study

Kulmala

Nykänen²,

Mänty³

et al. 2013

Gerontology

170

103

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Background: Frailty is commonly considered as a syndrome with several symptoms, including weight loss, exhaustion, weakness, slow walking speed and physical inactivity. It has been suggested that cognitive impairment should be included in the frailty index, however the association between frailty and cognition has not yet been fully established. Objective: To investigate cross-sectionally whether frailty is associated with cognitive impairment or clinically diagnosed dementia in older people. Methods: The study included a total of654 persons aged 76-100 years (mean 82 ± 4.6).Frailty status of the participants was assessed using the Cardiovascular Health Study criteria. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Clinically diagnosed dementia was assessed by specialists using diagnostic criteria. The associations between frailty and cognition were investigated using logistic regression. Results: A total of 93 (14%) participants were classified as frail. Cognitive impairment (MMSE score <25) was observed among 171 (26%) persons and 134 (21%) persons had clinically diagnosed dementia. 97 (15%) persons had Alzheimer's disease, 19 (3%) had vascular dementia, 12 (2%) had dementia with Lewy bodies and 8 persons (1%) had some other type of dementia. Multivariate logistic regression models showed that frail persons were almost 8 times more likely to have cognitive impairment (OR 7.8, 95% CI 4.0-15.0), 8 times more likely to have some kind of dementia (OR 8.0, 95% CI 4.0-15.9), almost 6 times more likely to have vascular dementia (OR 5.6, 95% CI 1.2-25.8) and over 4 times more likely to have Alzheimer's disease (OR 4.5, 95% CI 2.1-9.6) than persons who were robust. Conclusion: Frailty is strongly associated with cognitive impairment and clinically diagnosed dementia among persons aged 76 and older. It is possible that cognitive impairment is a clinical feature of frailty and therefore should be included in the frailty definition.

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“…Flow chart of retrieved and selected articles showing associations between the physical and cognitive domain A number of longitudinal studies have indicated that frailty was associated with low cognitive performance over time in older individuals with and without dementia (61-67) and crosssectional analyses, although limited, have also reported associations between physical frailty and cognitive decline (68,69). In the most recent prospective study, Gray et al observed that in a large population of older adults aged ≥ 65 years, frailty was associated with a 2.57-fold increased risk for non-AD dementia, although they did not observe any associations between frailty and all-cause dementia or AD (66).…”

Section: Figurementioning

confidence: 99%

Cognitive frailty: Rational and definition from an (I.A.N.A./I.A.G.G.) International Consensus Group

Kelaiditi

Cesari

Canevelli

et al. 2013

The Journal of nutrition, health and aging

762

550

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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.

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Mini-Mental State Examination performance in frail, pre-frail, and non-frail community dwelling older adults in Ermelino Matarazzo, São Paulo, Brazil

Abstract: Our data suggest that being frail is associated with worse cognitive performance, as assessed by the MMSE. It is recommended that the assessment of frail older adults should include the investigation of their cognitive status.

Cited by 93 publications

References 30 publications

Desempenho cognitivo e fragilidade em idosos clientes de operadora de saúde

Desempenho cognitivo e fragilidade em idosos clientes de operadora de saúde

Association between Frailty and Dementia: A Population-Based Study

Cognitive frailty: Rational and definition from an (I.A.N.A./I.A.G.G.) International Consensus Group

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