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Solfrizzi V, Scafato E, Seripa D, Lozupone M, Imbimbo BP, D'Amato A, Tortelli R, Schilardi A, Galluzzo L, Gandin C, Baldereschi M, Di Carlo A, Inzitari D, Daniele A, Sabbà C, Logroscino G, Panza F. Reversible Cognitive Frailty, Dementia, and All-Cause Mortality. The Italian Longitudinal Study on Aging. J Am Med Dir Assoc 2017; 18:89.e1-89.e8. [PMID: 28012505 DOI: 10.1016/j.jamda.2016.10.012] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 10/25/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Cognitive frailty, a condition describing the simultaneous presence of physical frailty and mild cognitive impairment, has been recently defined by an international consensus group. We estimated the predictive role of a "reversible" cognitive frailty model on incident dementia, its subtypes, and all-cause mortality in nondemented older individuals. We verified if vascular risk factors or depressive symptoms could modify this predictive role. DESIGN Longitudinal population-based study with 3.5- and 7-year of median follow-up. SETTING Eight Italian municipalities included in the Italian Longitudinal Study on Aging. PARTICIPANTS In 2150 older individuals from the Italian Longitudinal Study on Aging, we operationalized reversible cognitive frailty with the presence of physical frailty and pre-mild cognitive impairment subjective cognitive decline, diagnosed with a self-report measure based on item 14 of the Geriatric Depression Scale. MEASUREMENTS Incidence of dementia, its subtypes, and all-cause mortality. RESULTS Over a 3.5-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia [hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.02-5.18], particularly vascular dementia (VaD), and all-cause mortality (HR 1.74, 95% CI 1.07-2.83). Over a 7-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia (HR 2.12, 95% CI 1.12-4.03), particularly VaD, and all-cause mortality (HR 1.39, 95% CI 1.03-2.00). Vascular risk factors and depressive symptoms did not have any effect modifier on the relationship between reversible cognitive frailty and incident dementia and all-cause mortality. CONCLUSIONS A model of reversible cognitive frailty was a short- and long-term predictor of all-cause mortality and overall dementia, particularly VaD. The absence of vascular risk factors and depressive symptoms did not modify the predictive role of reversible cognitive frailty on these outcomes.
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Affiliation(s)
- Vincenzo Solfrizzi
- Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy
| | - Emanuele Scafato
- Population Health and Health Determinants Unit, National Center for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy
| | - Davide Seripa
- Gerontology-Geriatrics Research Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Madia Lozupone
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Bruno P Imbimbo
- Research and Development Department, Chiesi Farmaceutici, Parma, Italy
| | - Angela D'Amato
- Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy
| | - Rosanna Tortelli
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Andrea Schilardi
- Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy
| | - Lucia Galluzzo
- Population Health and Health Determinants Unit, National Center for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy
| | - Claudia Gandin
- Population Health and Health Determinants Unit, National Center for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy
| | - Marzia Baldereschi
- Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy
| | - Antonio Di Carlo
- Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy
| | - Domenico Inzitari
- Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy; Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy
| | - Antonio Daniele
- Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - Carlo Sabbà
- Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy
| | - Giancarlo Logroscino
- Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy
| | - Francesco Panza
- Gerontology-Geriatrics Research Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy.
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Solfrizzi V, Scafato E, Frisardi V, Seripa D, Logroscino G, Maggi S, Imbimbo BP, Galluzzo L, Baldereschi M, Gandin C, Di Carlo A, Inzitari D, Crepaldi G, Pilotto A, Panza F. Frailty syndrome and the risk of vascular dementia: The Italian Longitudinal Study on Aging. Alzheimers Dement 2012; 9:113-22. [DOI: 10.1016/j.jalz.2011.09.223] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 08/23/2011] [Accepted: 09/02/2011] [Indexed: 11/27/2022]
Affiliation(s)
- Vincenzo Solfrizzi
- Department of Geriatrics; Center for Aging Brain, Memory Unit, University of Bari; Bari Italy
| | - Emanuele Scafato
- Population Health and Health Determinants Unit; National Centre for Epidemiology, Surveillance; and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS); Roma Italy
| | - Vincenza Frisardi
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory; Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Foggia Italy
| | - Davide Seripa
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory; Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Foggia Italy
| | - Giancarlo Logroscino
- Department of Neurological and Psychiatric Sciences; University of Bari; Bari Italy
| | - Stefania Maggi
- Aging Section; Italian National Research Council (CNR), Aging Section; Padova Italy
| | - Bruno P. Imbimbo
- Research and Development Department; Chiesi Farmaceutici; Parma Italy
| | - Lucia Galluzzo
- Population Health and Health Determinants Unit; National Centre for Epidemiology, Surveillance; and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS); Roma Italy
| | - Marzia Baldereschi
- Department of Neurological and Psychiatric Sciences; University of Firenze; Firenze Italy
| | - Claudia Gandin
- Population Health and Health Determinants Unit; National Centre for Epidemiology, Surveillance; and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS); Roma Italy
| | - Antonio Di Carlo
- Department of Neurological and Psychiatric Sciences; University of Firenze; Firenze Italy
| | - Domenico Inzitari
- Institute of Neuroscience, Italian National Research Council (CNR); Firenze Italy
| | - Gaetano Crepaldi
- Aging Section; Italian National Research Council (CNR), Aging Section; Padova Italy
| | - Alberto Pilotto
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory; Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Foggia Italy
- Geriatric Unit, Azienda ULSS 16 Padova; S. Antonio Hospital; Padova Italy
| | - Francesco Panza
- Geriatric Unit and Gerontology-Geriatrics Research Laboratory; Department of Medical Sciences, IRCCS Casa Sollievo della Sofferenza; San Giovanni Rotondo Foggia Italy
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Abstract
This article is a psychometric evaluation of the experimental Geriatric and Extended Careline Depression Screen (GEDS) for geriatric nursing care residents. The GEDS is a five-item depression screen based on an abbreviated version of the Center for Epidemiological Studies Depression Scale (CES-D). A total sample of 91 male residents over the age of 60 were recruited from a Veterans Administration Nursing Home Care Unit. The Geriatric Depression Scale-Short Form (GDS-SF) was used as a gold standard test to examine the convergent validity of the GEDS. The Discriminant Trait Inventory was used to assess divergent validity and the confounding effects of method variance in this research design. Test-retest reliability, redundance and omission in item content validity were systematically evaluated. A receiver operating characteristics (ROC) curve was used to identify the most effective cut-off score for clinical selection. Reliability was significant, but moderate. Convergent validity with the Geriatric Depression Scale was high. No items were identified as redundant. A review of literature suggested that irritability is an important factor of geriatric depression that had not been included in the original screen. The inclusion of an experimental item to assess irritability, however, did not improve the psychometric properties of the GEDS.
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Affiliation(s)
- R H Lelito
- Veterans Administration of Western New York Health Care System, Behavioral Health Service, Buffalo 14215, USA.
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Gauggel S, Birkner B. Validität und Reliabilität einer deutschen Version der Geriatrischen Depressionsskala (GDS). ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 1999. [DOI: 10.1026//0084-5345.28.1.18] [Citation(s) in RCA: 164] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. In diesem Artikel berichten wir über die Validität und Reliabilität einer deutschen Version der “Geriatric Depression Scale (GDS)”. 43 Patienten im Alter zwischen 60 bis 87 Jahren wurden während ihres stationären Aufenthaltes auf einer psychiatrischen oder chirurgischen Station mit dem Mini-Mental-Status-Test, dem Diagnostischen Kurzinterview bei Psychischen Störungen (Mini-DIPS) und der GDS untersucht. Die GDS wies bei einem kritischen Wert von 13 Punkten die beste Sensitivität (84.0 %) und Spezifität (88.9 %) auf. Bei der 15-Item Kurzform der GDS konnte bei einem kritischen Wert von 6 die beste Sensitivität (84.0 %) und Spezifität (88.9 %) erzielt werden. Die mittlere Trennschärfe (.49), die mittlere Fragebogenschwierigkeit (P = 43), die niedrige Interitemkorrelation (r = .19) und die hohe innere Konsistenz (Cronbach alpha = .91) weisen die deutsche Version der GDS insgesamt als Fragebogen mit guten psychometrischen Eigenschaften aus.
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