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Ghanbarnia MJ, Hosseini SR, Ahangar AA, Ghadimi R, Bijani A. Prevalence of cognitive frailty and its associated factors in a population of Iranian older adults. Aging Clin Exp Res 2024; 36:134. [PMID: 38902508 PMCID: PMC11189957 DOI: 10.1007/s40520-024-02790-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/09/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND In recent years cognitive frailty has emerged as an important predictor of adverse health outcomes in older adults. Herein, we aimed to investigate the prevalence and associated factors of cognitive frailty in a population of community-dwelling older adults in Iran. METHOD This cross-sectional study was conducted as part of the second cycle of the Amirkola Health and Aging Project (AHAP). Physical frailty and cognitive impairment were evaluated using the FRAIL questionnaire and the mini-mental state examination (MMSE) respectively. Cognitive frailty was defined as co-existence of frailty and cognitive impairment without presence of dementia. Depression and disability were assessed using the Persian version of geriatric depression scale (GDS) and instrumental activities of daily living (IADL) questionnaire. RESULTS Overall 1775 individuals (47.1% female) with mean age of 69.7 ± 7.3 years were included in the final analysis. The prevalence of cognitive frailty was 12.0%. The prevalence of cognitive frailty among males and females was 4.3% and 20.7%, respectively. After adjusting for all possible confounders through binary logistic regression analysis, factors such as older age (OR 1.06, CI 1.03-1.09), female gender (OR 2.25, CI 1.42-3.57), illiteracy (OR 3.84, CI 2.03-8.29), more comorbidities (OR 1.21, CI 1.12-1.31), depression (OR 2.01, CI 1.40-2.86), and greater IADL disability (OR 1.68, CI 1.44-3.96), were independently and significantly associated with cognitive frailty. CONCLUSION In this population of Iranian older adults, prevalence of cognitive frailty was consistent with its estimated mean global prevalence. Age, gender, illiteracy, comorbidities, depression and IADL disability were associated with cognitive frailty. Further research is required to develop screening tools and prevention strategies.
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Affiliation(s)
- Mohammad Javad Ghanbarnia
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Department of Ophthalmology, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Alijan Ahmadi Ahangar
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Reza Ghadimi
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Fatin Malek Rivan N, Murukesu RR, Shahar S, Fadilah Rajab N, Subramaniam P, Choon Ooi T, Zul Amin Kamaruddin M, Singh DKA. Synergistic effects of cognitive frailty and comorbidities on disability: a community-based longitudinal study. BMC Geriatr 2024; 24:448. [PMID: 38778287 PMCID: PMC11112824 DOI: 10.1186/s12877-024-05057-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVE In this study, we aimed to assess the synergistic effects of cognitive frailty (CF) and comorbidity on disability among older adults. METHODS Out of the 1318 participants from the Malaysian Towards Useful Aging (TUA) study, only 400 were included in the five-year follow-up analysis. A comprehensive interview-based questionnaire covering socio-demographic information, health status, biochemical indices, cognitive and physical function, and psychosocial factors was administered. Binary logistic regression analysis was employed to estimate the independent and combined odd ratios (ORs). Measures such as the relative excess risk due to interaction (RERI), the attributable proportion of risk due to the interaction, and the synergy index were used to assess the interaction between CF and comorbidity. RESULTS Participants with CF (24.1%) were more likely to report disability compared to those without CF (10.3%). Synergistic effects impacting disability were observed between CF and osteoarthritis (OA) (OR: 6.675, 95% CI: 1.057-42.158; RERI: 1.501, 95% CI: 1.400-1.570), CF and heart diseases (HD) (OR: 3.480, 95% CI: 1.378-8.786; RERI: 0.875, 95% CI: 0.831-0.919), CF and depressive symptoms (OR: 3.443, 95% CI: 1.065-11.126; RERI: 0.806, 95% CI: 0.753-0.859), and between CF and diabetes mellitus (DM) (OR: 2.904, 95% Confidence Interval (CI): 1.487-5.671; RERI: 0.607, 95% CI: 0.577-0.637). CONCLUSION These findings highlight the synergism between the co-existence of CF and comorbidity, including OA, HD, DM, and depressive symptoms, on disability in older adults. Screening, assessing, and managing comorbidities, especially OA, HD, DM and depressive symptoms, when managing older adults with CF are crucial for reducing the risk of or preventing the development of disability.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Resshaya Roobini Murukesu
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
- TUM School of Medicine & Health, Department of Health and Sport Sciences, Technical University of Munich, Munich, Germany
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Nor Fadilah Rajab
- Biomedical Science Programme, Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Ponnusamy Subramaniam
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Theng Choon Ooi
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
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Ye Y, Wan M, Lin H, Xia R, He J, Qiu P, Zheng G. Effects of Baduanjin exercise on cognitive frailty, oxidative stress, and chronic inflammation in older adults with cognitive frailty: a randomized controlled trial. Front Public Health 2024; 12:1385542. [PMID: 38846613 PMCID: PMC11153822 DOI: 10.3389/fpubh.2024.1385542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/10/2024] [Indexed: 06/09/2024] Open
Abstract
Background Oxidative stress and chronic inflammation play an important role in the pathogenesis process of cognitive frailty (CF). Regular Baduanjin exercise could improve cognitive frailty in older adults, but it is unclear whether the effect of Baduanjin exercise on improving CF is mediated by modulating circulating oxidative stress and inflammatory process. Method A total of 102 community-dwelling older adults with CF were recruited and randomly allocated into a 24-week Baduanjin exercise training group or no specific exercise intervention control group at an equal rate. Cognitive function and physical frailty index were assessed using the Montreal Cognitive Assessment (MoCA) and the Edmonton Frail Scale (EFS), as well as the oxidative stress and inflammatory cytokines were measured at baseline and after intervention. Result After 24 weeks of intervention, the increased MoCA score (2.51 ± 0.32 points, p < 0.001) and the decreased EFS scores (1.94 ± 0.20 points, p = 0.012) in the Baduanjin group were significantly higher than those in the control group. Serum antioxidant SOD levels were increased by 10.03 ± 4.73 U/mL (p < 0.001), and the prooxidative MDA and 8-iso-PGF2α levels were decreased by -1.08 ± 0.80 nmol/mL (p = 0.030) and -86.61 ± 15.03 ng/L (p < 0.001) in the Baduanjin training group; while inflammatory cytokines IFN-γ, IL-2 and IL-4 levels were increased (1.08 ± 0.33 pg./mL, p = 0.034, 2.74 ± 0.75 pg./mL, p = 0.04 and 1.48 ± 0.35 pg./mL, p = 0.042). In addition, a mediation effect that Baduanjin training improved cognitive ability mediated by an increase of circulating IFN-γ and IL-2 levels were observed in this study. Conclusion Regular Baduanjin exercise training could improve the cognitive frailty of the community-dwelling older adults with CF, and modulate oxidative stress and inflammatory processes by reducing circulating pro-oxidative MDA and 8-iso-PGF2α levels and increasing anti-oxidative SOD levels, as well as impacting inflammatory cytokines IFN-γ, IL-2, and IL-4 levels. Nevertheless, the mechanism of Baduanjin exercise mediating oxidative stress and inflammatory processes should be cautious to be explained. Clinical trial registration http://www.chictr.org.cn/index.aspx, ChiCTR1800020341.
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Affiliation(s)
- Yu Ye
- College of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
- Medical School of Chinese PLA, Chinese PLA General Hospital, Beijing, China
- Department of Rehabilitation Medicine, The Second Medical Center, Chinese PLA General Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Mingyue Wan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huiying Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Rui Xia
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Jianquan He
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Pingting Qiu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Guohua Zheng
- College of Nursing and Health Management, Shanghai University of Medicine & Health Sciences, Shanghai, China
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Yuan C, Zhang Y. Modifiable risk factors of cognitive frailty in community-dwelling older adults: A systematic review and meta-analysis. Int J Nurs Knowl 2024; 35:177-185. [PMID: 37378541 DOI: 10.1111/2047-3095.12437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To perform a meta-analysis identifying the modifiable risk factors of cognitive frailty in the elderly. METHODS We systematically searched databases including PubMed, EMBASE, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Data Knowledge Service Platform from January 01, 2017 to March 26, 2022. Quantitative, original research reporting associated factors were included. FINDINGS 7,854 records in total were identified, of which 14 articles (1 prospective, 13 cross-sectional) with 36 factors were included. Studies on cognitive frailty included 20,390 community-dwellers (≥60 years) from three countries. Meta-analysis indicated that depression [OR = 3.60, 95%CI (2.25,5.78), p < 0.01] and sleep problems [OR = 2.36, 95%CI (1.62,3.43), p < 0.01] were associated with cognitive frailty. CONCLUSIONS Effective interventions targeting depression and sleep problems may lower the risk of cognitive frailty in the community seniors but need further study in high-quality, prospective studies. IMPLICATIONS FOR NURSING PRACTICE Building on previous work, the objectives of this systematic review and meta-analysis were to explore potential modifiable risk factors for cognitive frailty in community-dwelling older adults, which is expected to throw light on the prevention of cognitive frailty.
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Affiliation(s)
- Chen Yuan
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yixiong Zhang
- Department of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
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Wang Y, Xu X, Lv Q, Zhang X, Yang W, Li Y, Zhao Y, Zang X. The Association Between Impaired Dyadic Coping and Frailty in Elderly Patients With Hypertension: A Latent Profile Analysis. J Cardiovasc Nurs 2024:00005082-990000000-00175. [PMID: 38456911 DOI: 10.1097/jcn.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Lifelong hypertension highlights the importance of dyadic engagement in coping with the disease. Although dyadic coping is heterogeneous in patients with other diseases, little is known about it in elderly patients with hypertension. In addition, whether impaired dyadic coping is associated with frailty has yet to be elucidated. OBJECTIVES The aim of this study was to investigate the latent profiles and characteristics of dyadic coping and the potential association between impaired dyadic coping and frailty in elderly patients with hypertension. METHODS We recruited a total of 741 elderly patients with hypertension. Latent profile analysis was then used to identify the best-fitting model. Then, we used regression analysis to determine profile predictors and identify the association between impaired dyadic coping and frailty. RESULTS The 5-profile model was considered to be the best-fitting model, as follows: profile 1, severely impaired dyadic coping; profile 2, mildly impaired dyadic coping; profile 3, normal dyadic coping; profile 4, better dyadic coping; and profile 5, the highest dyadic coping. In the fully adjusted model, the probability of frailty was 1.94-fold higher in the mildly impaired dyadic coping group (odds ratio, 1.94; 95% confidence interval, 1.09-3.47) and 2.66-fold higher in the severely impaired dyadic coping group (odds ratio, 2.66; 95% confidence interval, 1.11-6.39). CONCLUSIONS We identified heterogeneity in dyadic coping and demonstrated that impaired dyadic coping was associated with frailty. Those at risk of dyadic coping impairment need to be identified early, followed by dyadic coping-based interventions to prevent or delay frailty.
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Ijaz N, Jamil Y, Brown CH, Krishnaswami A, Orkaby A, Stimmel MB, Gerstenblith G, Nanna MG, Damluji AA. Role of Cognitive Frailty in Older Adults With Cardiovascular Disease. J Am Heart Assoc 2024; 13:e033594. [PMID: 38353229 PMCID: PMC11010094 DOI: 10.1161/jaha.123.033594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 02/21/2024]
Abstract
As the older adult population expands, an increasing number of patients affected by geriatric syndromes are seen by cardiovascular clinicians. One such syndrome that has been associated with poor outcomes is cognitive frailty: the simultaneous presence of cognitive impairment, without evidence of dementia, and physical frailty, which results in decreased cognitive reserve. Driven by common pathophysiologic underpinnings (eg, inflammation and neurohormonal dysregulation), cardiovascular disease, cognitive impairment, and frailty also share the following risk factors: hypertension, diabetes, obesity, sedentary behavior, and tobacco use. Cardiovascular disease has been associated with the onset and progression of cognitive frailty, which may be reversible in early stages, making it essential for clinicians to diagnose the condition in a timely manner and prescribe appropriate interventions. Additional research is required to elucidate the mechanisms underlying the development of cognitive frailty, establish preventive and therapeutic strategies to address the needs of older patients with cardiovascular disease at risk for cognitive frailty, and ultimately facilitate targeted intervention studies.
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Affiliation(s)
- Naila Ijaz
- Thomas Jefferson University HospitalPhiladelphiaPAUSA
| | - Yasser Jamil
- Yale University School of MedicineNew HavenCTUSA
| | | | | | - Ariela Orkaby
- New England GRECC, VA Boston Healthcare SystemBostonMAUSA
- Division of AgingBrigham & Women’s Hospital, Harvard Medical SchoolBostonMAUSA
| | | | | | | | - Abdulla A. Damluji
- Johns Hopkins University School of MedicineBaltimoreMDUSA
- The Inova Center of Outcomes ResearchInova Heart and Vascular InstituteFalls ChurchVAUSA
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Xu J, Xiang L, Zhang H, Sun X, Xu D, Wu D, Chen C, Zhang Y, Gu Z. Prevalence and modifiable risk factors of cognitive frailty in patients with chronic heart failure in China: a cross-sectional study. BMC Cardiovasc Disord 2024; 24:93. [PMID: 38326774 PMCID: PMC10848518 DOI: 10.1186/s12872-024-03753-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Cognitive frailty (CF) is currently a significant issue, and most of the associated factors discovered in current studies are not modifiable. Therefore, it is crucial to identify modifiable risk factors that can be targeted for interventions in patients with chronic heart failure (CHF). This study aimed to investigate the prevalence and modifiable risk factors of CF in CHF patients in China. METHODS In this cross-sectional study, we sequentially enrolled patients diagnosed with CHF. CF served as the dependent variable, assessed through the Montreal Cognitive Assessment (MoCA) Scale and the FRAIL Scale. The independent variable questionnaire encompassed various components, including general demographic information, the Social Support Rating Scale (SSRS), the Simplified Nutrition Appetite Questionnaire (SNAQ), the Hamilton Depression Scale (HAMD), the Hamilton Anxiety Scale (HAMA), and the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Logistic regression analysis was employed to identify independent factors contributing to CF. RESULTS A total of 271 patients with CHF were included in the study. The overall prevalence of CF was found to be 49.4%, with 28.8% of patients exhibiting potentially reversible cognitive frailty and 20.7% showing reversible cognitive frailty. Among middle-young CHF patients, 10.7% had reversible cognitive frailty and 6.4% had potentially reversible cognitive frailty, with a prevalence of CF at 17.1%. Logistic regression analysis revealed that body mass index (OR = 0.826, 95%CI = 0.726-0.938), blood pressure level (OR = 2.323, 95%CI = 1.105-4.882), nutrition status (OR = 0.820, 95%CI = 0.671-0.979), and social support (OR = 0.745, 95%CI = 0.659-0.842) were independent factors associated with CF (p < 0.05). CONCLUSIONS We observed a relatively high prevalence of CF among Chinese patients diagnosed with CHF. Many factors including BMI, blood pressure level, nutrition status, and social support emerging as modifiable risk factors associated with CF. We propose conducting clinical trials to assess the impact of modifying these risk factors. The outcomes of this study offer valuable insights for healthcare professionals, guiding them in implementing effective measures to improve the CF status in CHF patients during clinical practice.
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Affiliation(s)
- Jiayi Xu
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China
| | - Luwei Xiang
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China
| | - Huichao Zhang
- The Second Hospital of Nanjing, Affiliated to Nanjing University of Chinese Medicine, 1-1 Zhongfu Road, Nanjing, Jiangsu, 210003, China
| | - Xing Sun
- Nanjing Women and Children's Healthcare Hospital, 123 Tianfei Road, Nanjing, Jiangsu, 210004, China
| | - Dongmei Xu
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China
| | - Die Wu
- Jiangsu Province Hospital of Chinese Medicine, 155 Hanzhong Road, Nanjing, Jiangsu, 210029, China
- The First Clinical Medical College, Nanjing University of Chinese Medicine, 282 Hanzhong Road, Nanjing, Jiangsu, 210029, China
| | - Chen Chen
- School of Nursing, Nanjing Medical University, 101 Longmian Road, Nanjing, Jiangsu, 211166, China
| | - Yixiong Zhang
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China.
| | - Zejuan Gu
- School of Nursing, Nanjing University of Chinese Medicine, 138 Xianlin Road, Nanjing, Jiangsu, 210023, China.
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, 300 Guangzhou Road, Nanjing, Jiangsu, 210029, China.
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Peng J, Ming L, Wu J, Li Y, Yang S, Liu Q. Prevalence and related factors of cognitive frailty in diabetic patients in China: a systematic review and meta-analysis. Front Public Health 2023; 11:1249422. [PMID: 37927856 PMCID: PMC10620522 DOI: 10.3389/fpubh.2023.1249422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Objective Cognitive frailty (CF) is characterized by physical frailty and potentially reversible cognitive impairment without Alzheimer's disease and other dementias. Clarifying the prevalence and related factors of cognitive frailty can help researchers understand its epidemiological status and formulate intervention measures. This study aims to conduct a systematic review and meta-analysis of the prevalence and related factors of CF in diabetic patients in Chinas to better understand the current status of CF in diabetic patients in China and develop effective intervention measures for related factors. Methods PubMed, Web of Science, Embase, Cochrane Library, CNKI, Weipu(VIP), WANFANG, China Biology Medicine (CBM) and DUXIU were searched to collect epidemiological data on Chinese diabetic patients. Articles published through May 29, 2023, were searched. The number of diabetes with CF and the total number of diabetes in the included studies were extracted to estimate the prevalence of diabetes with CF. For factors related to diabetes with CF, odds ratios (OR) and 95% confidence intervals (CI) were used for estimation. Results A total of 248 records were screened, of which 18 met the inclusion criteria. The results of meta-analysis showed that the prevalence of Chinese diabetic patients with CF was 25.8% (95% CI = 19.7 to 31.9%). Subgroup analysis showed that hospital prevalence was higher than in the community and in women than in men. Combined estimates showed that depression, malnutrition, advanced age (≥70, ≥80), combined chronic diseases ≥4 and glycated hemoglobin ≥8.5 were risk factors for CF in diabetics patients in China, with regular exercise and high education level (≥ college) as protective factors. Conclusion Cognitive frailty was common in diabetic patients in China. Such populations should be screened early and intervened with relevant factors.Systematic review registration: A systematic review of this study evaluated the registered websites as https://www.crd.york.ac.uk/PROSPERO/, CRD42023431396.
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Affiliation(s)
- Junjie Peng
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Limei Ming
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Jiaming Wu
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Yunchuan Li
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
| | - Shuhua Yang
- The First People's Hospital of Yunnan Province, Kunming, Yunnan, China
| | - Qin Liu
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, China
- Postdoctoral Research Station of Public Administration, Yunnan University, Kunming, Yunnan, China
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Jiao D, Li X, Zhu Z, Zhang J, Liu Y, Cui M, Matsumoto M, Banu AA, Sawada Y, Watanabe T, Tanaka E, Anme T. Latent Subtype of Cognitive Frailty among Multimorbidity Older Adults and Their Association with Social Relationships. Healthcare (Basel) 2023; 11:1933. [PMID: 37444767 DOI: 10.3390/healthcare11131933] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/18/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to explore all the relevant subtypes of cognitive frailty among Japanese community-dwelling older adults with multimorbidity. Moreover, it examined the associations between these potential subtypes of cognitive frailty and social relationships. This study targeted relevant cross-sectional data regarding community-based older adults with multimorbidity. It employed a person-centered method to perform a latent class analysis and explore the subtypes of cognitive frailty among older adults. Moreover, a multinominal logistic regression analysis was employed to examine the association between potential subtypes of cognitive frailty and social relationships. Data for 396 participants (mean age, 75.8 [SD, 7.3] years; 51.3% females) were analyzed. Three cognitive frailty subtypes were subsequently revealed: the robust group (42.0%), the group with partial cognitive frailty (38.6%), and the group with cognitive frailty (19.4%). People with high levels of social relationships were more likely to be in the robust and the partial cognitive frailty groups. This study identified different subtypes of cognitive frailty among multimorbid older adults and highlighted the significance of social relationships. These findings could serve as a reference for conceptualizing cognitive frailty through the person-centered method. Promoting a high level of social relationships could be useful to prevent the cognitive frailty among older adults with multimorbidity.
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Affiliation(s)
- Dandan Jiao
- Department of Nursing, The First Affiliated Hospital, and College of Clinical Medicine, Henan University of Science and Technology, Luoyang 471003, China
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Xiang Li
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Zhu Zhu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Jinrui Zhang
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Yang Liu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Mingyu Cui
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Munenori Matsumoto
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Alpona Afsari Banu
- School of Comprehensive Human Science, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Yuko Sawada
- Department of Physical Therapy, Morinomiya University of Medical Sciences, Osaka 559-0034, Japan
| | - Taeko Watanabe
- Faculty of Nursing, Shukutoku University, Chiba 260-8701, Japan
| | - Emiko Tanaka
- Faculty of Nursing, Musashino University, Tokyo 135-8181, Japan
| | - Tokie Anme
- Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan
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10
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Panza F, Solfrizzi V, Sardone R, Dibello V, Castellana F, Zupo R, Stallone R, Lampignano L, Bortone I, Mollica A, Berardino G, Ruan Q, Altamura M, Bellomo A, Daniele A, Lozupone M. Depressive and Biopsychosocial Frailty Phenotypes: Impact on Late-life Cognitive Disorders. J Alzheimers Dis 2023:JAD230312. [PMID: 37355907 DOI: 10.3233/jad-230312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
In older age, frailty is a detrimental transitional status of the aging process featuring an increased susceptibility to stressors defined by a clinical reduction of homoeostatic reserves. Multidimensional frailty phenotypes have been associated with all-cause dementia, mild cognitive impairment (MCI), Alzheimer's disease (AD), AD neuropathology, vascular dementia, and non-AD dementias. In the present article, we reviewed current evidence on the existing links among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders, also examining common pathways and mechanisms underlying these links. The depressive frailty phenotype suggested by the construct of late-life depression (LLD) plus physical frailty is poorly operationalized. The biopsychosocial frailty phenotype, with its coexistent biological/physical and psychosocial dimensions, defines a biological aging status and includes motivational, emotional, and socioeconomic domains. Shared biological pathways/substrates among depressive and biopsychosocial frailty phenotypes and late-life cognitive disorders are hypothesized to be inflammatory and cardiometabolic processes, together with multimorbidity, loneliness, mitochondrial dysfunction, dopaminergic neurotransmission, specific personality traits, lack of subjective/objective social support, and neuroendocrine dysregulation. The cognitive frailty phenotype, combining frailty and cognitive impairment, may be a risk factor for LLD and vice versa, and a construct of depressive frailty linking physical frailty and LLD may be a good dementia predictor. Frailty assessment may enable clinicians to better target the pharmacological and psychological treatment of LLD. Given the epidemiological links of biopsychosocial frailty with dementia and MCI, multidomain interventions might contribute to delay the onset of late-life cognitive disorders and other adverse health-related outcomes, such as institutionalization, more frequent hospitalization, disability, and mortality.
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Affiliation(s)
- Francesco Panza
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Vincenzo Solfrizzi
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
| | - Rodolfo Sardone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Vittorio Dibello
- "Cesare Frugoni" Internal and Geriatric Medicine and Memory Unit, University of Bari "Aldo Moro", Bari, Italy
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Fabio Castellana
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Zupo
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Roberta Stallone
- Neuroscience and Education, Human Resources Excellence in Research, University of Foggia, Foggia, Italy
| | - Luisa Lampignano
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Ilaria Bortone
- Unit of Research Methodology and Data Sciences for Population Health, National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Anita Mollica
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Berardino
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Qingwei Ruan
- Laboratory of Aging, Anti-aging & Cognitive Performance, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Shanghai Medical 14 College, Fudan University, Shanghai, China
| | - Mario Altamura
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonello Bellomo
- Psychiatric Unit, Department of Clinical & Experimental Medicine, University of Foggia, Foggia, Italy
| | - Antonio Daniele
- Department of Neuroscience, Catholic University of Sacred Heart, Rome, Italy
- Neurology Unit, IRCCS Fondazione Policlinico Universitario A. Gemelli, Rome, Italy
| | - Madia Lozupone
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari Aldo Moro, Bari, Italy
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Liu J, Xu S, Wang J, Yan Z, Wang Z, Liang Q, Luan X. Prevalence of cognitive frailty among older adults in China: a systematic review and meta-analysis. BMJ Open 2023; 13:e066630. [PMID: 37076151 PMCID: PMC10124291 DOI: 10.1136/bmjopen-2022-066630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
OBJECTIVE This study aimed to investigate the prevalence of cognitive frailty among older adults in China. DESIGN Systematic review and meta-analysis. METHODS We searched the Cochrane Library, PubMed, Web of Science, Embase, China National Knowledge Infrastructure(CNKI), Wanfang, Chinese Biomedical Literature and Weipu (VIP) databases to collect information on the epidemiology of cognitive frailty among older adults in China. The study period was from the establishment of the database to March 2022. Two researchers independently screened the literature, extracted the data and assessed the risk of bias in the included studies. All statistical analyses were performed using Stata V.15.0. RESULTS We screened 522 records, of which 28 met the inclusion criteria. The results of the meta-analysis showed that the prevalence of cognitive frailty among older adults in China was 15%(95%CI (0.13%,0.17%)). The prevalence of cognitive frailty was higher in hospitals and nursing homes than in communities. Moreover, the prevalence of cognitive frailty was higher in women than in men. Furthermore, the prevalence rates of cognitive frailty in North China Hospital, older adults aged≥80 years, and illiterate individuals were 25%, 29%, and 55%, respectively. CONCLUSIONS In conclusion, in China, the prevalence of cognitive frailty is higher among older adults, is higher in women than in men, is higher in hospitals and nursing homes than in communities, and is higher in North China than other regions. Moreover, the higher the educational level, the lower the prevalence of cognitive frailty. Multimodal interventions for cognitive frailty, including increased exercise, nutritional support, increased socialisation opportunities and multifactorial strategies, may be effective in preventing cognitive frailty. These findings have important implications for adjusting healthcare and social care systems. PROSPERO REGISTRATION NUMBER CRD42023390486.
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Affiliation(s)
- Jian Liu
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Shengjia Xu
- The First Clinical College, Shandong University, Jinan, Shandong, China
| | - Jiurui Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zeping Yan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Zhiwei Wang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qian Liang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaorong Luan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- Department of Infection Control, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Zou C, Yu Q, Wang C, Ding M, Chen L. Association of depression with cognitive frailty: A systematic review and meta-analysis. J Affect Disord 2023; 320:133-139. [PMID: 36183817 DOI: 10.1016/j.jad.2022.09.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND AND AIM The relationship between cognitive frailty and depression is unclear and quantitative analyses are lacking. We conducted a systematic review and meta-analysis to investigate the relationship between cognitive frailty and depression. METHODS We systematically searched Embase, PubMed, Medline (Ovid), Web of Science, and APA PsycInfo (American Psychological Association PsycInfo) databases until April 2022. Meta-analysis was performed using the Stata software. The prevalence between cognitive frailty and depression them was estimated by extracting the proportion of cognitive frailty and depression in the total number of patients. We extracted odds ratios (ORs) and 95 % confidence intervals (CI) to estimate the relationship between cognitive frailty and depression. RESULTS A meta-analysis of 15 studies revealed that cognitive frailty in older adults was associated with a higher risk of depression (OR = 2.06, 95 % CI = 1.72-2.48, p = 0.001). Eight studies involved the prevalence of cognitive frailty and depression, with an overall prevalence of depression of 46 % (95 % CI, 30 % -62 %; p < 0.0001) in cognitively frail patients. LIMITATION Differences in definitions and assessment methods for cognitive frailty across studies. CONCLUSION The prevalence of cognitive frailty combined with depression in the elderly is high wherein both are mutually affected. More prospective studies are needed to investigate the relationship between cognitive frailty and depression and to propose targeted treatment options and preventive measures to improve the quality of life of the elderly population.
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Affiliation(s)
- Chuan Zou
- Department of General Practice, Chengdu Fifth People's Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu City, China
| | - Qian Yu
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - ChunYan Wang
- Department of medicine, JingGangshan University, Ji'an, Jiangxi province, China
| | - Mei Ding
- College of Nursing, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Lan Chen
- Department of Neurology, Affiliated Hospital of Jinggangshan University, JingGangshan University, Ji'an, Jiangxi province, China.
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Lyu Q, Guan CX, Kong LN, Zhu JL. Prevalence and risk factors of cognitive frailty in community-dwelling older adults with diabetes: A systematic review and meta-analysis. Diabet Med 2023; 40:e14935. [PMID: 35962598 DOI: 10.1111/dme.14935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/19/2022] [Accepted: 08/05/2022] [Indexed: 11/30/2022]
Abstract
AIMS Cognitive frailty can increase the risk of adverse health outcomes in older adults. Estimates of the prevalence of cognitive frailty among older adults with diabetes varied widely in literature. This study aimed to conduct a systematic review and meta-analysis to assess the pooled prevalence of cognitive frailty and risk factors in community-dwelling older adults with diabetes, providing evidence for healthcare professionals to better understand the status of cognitive frailty and help develop effective interventions. METHODS Databases of PubMed, Web of Science, Cochrane Library, Embase, Cumulative Index of Nursing and Allied Health, Proquest, China National Knowledge Infrastructure and China Biology Medicine were searched from inception to February 10th, 2022. The reviewers independently selected studies, extracted data and assessed the quality of studies. Pooled prevalence of cognitive frailty and risk factors were estimated. Subgroup analysis, meta-regression analysis, sensitivity analysis and publication bias were also conducted. RESULTS A total of 15 studies with 6391 participants were included in this review. The pooled prevalence of cognitive frailty was 11% (95%CI = 7.9-14%) in community-dwelling older adults with diabetes. Pooled estimates showed that increasing age, higher level of HbA1c, shorter night sleep duration and depression were risk factors, and regular exercise was the protective factor of cognitive frailty in community-dwelling older adults with diabetes. CONCLUSION Cognitive frailty was common in community-dwelling older adults with diabetes. Routine screening of cognitive frailty and effective interventions should be implemented for this population in community settings. REGISTRATION PROSPERO ID CRD42021276973.
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Affiliation(s)
- Qiong Lyu
- Department of General Practice, The first Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Chi-Xun Guan
- School of Nursing, Dalian University, Dalian, China
| | - Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Jia-Lu Zhu
- School of Nursing, Chongqing Medical University, Chongqing, China
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14
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Wang C, Chong Y, Wang L, Wang Y. The Correlation Between Falls and Cognitive Frailty in Elderly Individuals With Hypertension in a Chinese Community. Front Aging Neurosci 2022; 14:783461. [PMID: 35645780 PMCID: PMC9131718 DOI: 10.3389/fnagi.2022.783461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundCognitive frailty refers to the presence of both physical frailty and mild cognitive impairment without simultaneous diagnosis of Alzheimer's disease or other dementia. Epidemiological studies have confirmed the correlation between falls and cognitive frailty, but no study has investigated the relationship between fall risk and cognitive frailty in hypertensive elderly Chinese individuals.MethodsFrom December 2020 to March 2021, during face-to-face interviews, community-dwelling elderly individuals with hypertension aged 60~89 in Pudong New Area, Shanghai, were evaluated for cognitive frailty, fall history, and depression, and sociodemographic characteristics were collected. Logistic regression was used to analyze the correlation between falls and cognitive frailty.ResultsA total of 305 elderly people were investigated in this study, and 173 (56.7%, 95% CI =51.2%~62.2%) reported falling once or more in the previous year. Cognitive frailty is closely related to falls and was an independent risk factor for falls (OR = 2.661, 95% CI = 1.063~6.659). Other risk factors included old age (OR = 4.306, 95% CI = 1.852~10.013), female sex (OR = 1.988, 95% CI = 1.185~3.335) and depression (OR = 2.936, 95% CI = 1.069~8.060).ConclusionCognitive frailty is an important risk factor for falls in elderly individuals with hypertension in Chinese communities.
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Affiliation(s)
- Can Wang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
| | - Yue Chong
- Division of Medical Humanities and Behavioral Sciences, School of Medicine, Tongji University, Shanghai, China
| | - Ling Wang
- Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, School of Medicine, Tongji University, Shanghai, China
- Ling Wang
| | - Yanbo Wang
- Division of Medical Humanities and Behavioral Sciences, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Yanbo Wang
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