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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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Pasieczna AH, Szczepanowski R, Sobecki J, Katarzyniak R, Uchmanowicz I, Gobbens RJJ, Kahsin A, Dixit A. Importance analysis of psychosociological variables in frailty syndrome in heart failure patients using machine learning approach. Sci Rep 2023; 13:7782. [PMID: 37179399 PMCID: PMC10182994 DOI: 10.1038/s41598-023-35037-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 05/11/2023] [Indexed: 05/15/2023] Open
Abstract
The prevention and diagnosis of frailty syndrome (FS) in cardiac patients requires innovative systems to support medical personnel, patient adherence, and self-care behavior. To do so, modern medicine uses a supervised machine learning approach (ML) to study the psychosocial domains of frailty in cardiac patients with heart failure (HF). This study aimed to determine the absolute and relative diagnostic importance of the individual components of the Tilburg Frailty Indicator (TFI) questionnaire in patients with HF. An exploratory analysis was performed using machine learning algorithms and the permutation method to determine the absolute importance of frailty components in HF. Based on the TFI data, which contain physical and psychosocial components, machine learning models were built based on three algorithms: a decision tree, a random decision forest, and the AdaBoost Models classifier. The absolute weights were used to make pairwise comparisons between the variables and obtain relative diagnostic importance. The analysis of HF patients' responses showed that the psychological variable TFI20 diagnosing low mood was more diagnostically important than the variables from the physical domain: lack of strength in the hands and physical fatigue. The psychological variable TFI21 linked with agitation and irritability was diagnostically more important than all three physical variables considered: walking difficulties, lack of hand strength, and physical fatigue. In the case of the two remaining variables from the psychological domain (TFI19, TFI22), and for all variables from the social domain, the results do not allow for the rejection of the null hypothesis. From a long-term perspective, the ML based frailty approach can support healthcare professionals, including psychologists and social workers, in drawing their attention to the non-physical origins of HF.
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Affiliation(s)
| | - Remigiusz Szczepanowski
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland.
| | - Janusz Sobecki
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Radosław Katarzyniak
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Robbert J J Gobbens
- Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, the Netherlands
- Department Family Medicine and Population Health, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands
- Zonnehuisgroep Amstelland, Amstelveen, the Netherlands
| | | | - Anant Dixit
- Department of Computer Science and Systems Engineering, Faculty of Information and Communication Technology, Wroclaw University of Science and Technology, Wyb. Wyspiańskiego 27, 50-370, Wroclaw, Poland
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Yap NLX, Kor Q, Teo YN, Teo YH, Syn NL, Mance Evangelista LK, Tan BY, Lin W, Yeo LL, Kong WK, Chong YF, Wong RC, Poh KK, Yeo TC, Sharma VK, Chai P, Chan MY, Goh FQ, Sia CH. Prevalence and Incidence of Cognitive Impairment and Dementia in Heart Failure - A Systematic Review, Meta-Analysis and Meta-Regression. Hellenic J Cardiol 2022; 67:48-58. [PMID: 35839985 DOI: 10.1016/j.hjc.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/14/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The burden of cognitive impairment in HF patients is significant and leads to longer hospital stay, higher readmission rates, and increased mortality. This review seeks to synthesize the available studies to determine the prevalence and incidence of cognitive impairment and dementia in HF patients. METHODS PubMed, Embase, PsychoINFO and Cochrane databases were systematically searched from their inception through to 3 May 2021. Study and population characteristics, total patients with HF, prevalence of cognitive impairment and dementia in HF patients and cognitive assessment tool were abstracted by two reviewers. RESULTS In heart failure patients, overall prevalence for cognitive impairment and dementia was 41.42% (CI) and 19.79% (dementia) respectively. We performed a meta-regression analysis which demonstrated that the risk of cognitive impairment and dementia increased with age. DISCUSSION Further research should investigate whether HF accelerates the rate of cognitive decline and the progression of dementia.
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Affiliation(s)
- Nicole Li Xian Yap
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Qianyi Kor
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Yao Neng Teo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Yao Hao Teo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Nicholas L Syn
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228
| | - Lauren Kay Mance Evangelista
- Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Benjamin Yq Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - Weiqin Lin
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Leonard Ll Yeo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - William Kf Kong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Yao Feng Chong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - Raymond Cc Wong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Kian Keong Poh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Tiong-Cheng Yeo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Vijay Kumar Sharma
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Division of Neurology, Department of Medicine, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
| | - Ping Chai
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Mark Y Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Fang Qin Goh
- Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228
| | - Ching-Hui Sia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228.
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Jiang Y, Wang L, Lu Z, Chen S, Teng Y, Li T, Li Y, Xie Y, Zhao M. Brain Imaging Changes and Related Risk Factors of Cognitive Impairment in Patients With Heart Failure. Front Cardiovasc Med 2022; 8:838680. [PMID: 35155623 PMCID: PMC8826966 DOI: 10.3389/fcvm.2021.838680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 12/31/2021] [Indexed: 12/13/2022] Open
Abstract
Background/Aims To explore the imaging changes and related risk factors of heart failure (HF) patients with cognitive impairment (CI). Methods A literature search was systematically carried out in PubMed, Web of Science, Embase, and Cochrane Library. In this systematic review, important relevant information was extracted according to the inclusion and exclusion criteria. The methodological quality was assessed by three scales according to the different study types. Results Finally, 66 studies were included, involving 33,579 patients. In the imaging changes, the severity of medial temporal lobe atrophy (MTA) and the decrease of gray Matter (GM) volume were closely related to the cognitive decline. The reduction of cerebral blood flow (CBF) may be correlated with CI. However, the change of white matter (WM) volume was possibly independent of CI in HF patients. Specific risk factors were analyzed, and the data indicated that the increased levels of B-type natriuretic peptide (BNP)/N-terminal pro-B-type natriuretic peptide (NT-proBNP), and the comorbidities of HF, including atrial fibrillation (AF), diabetes mellitus (DM) and anemia were definitely correlated with CI in patients with HF, respectively. Certain studies had also obtained independent correlation results. Body mass index (BMI), depression and sleep disorder exhibited a tendency to be associated with CI. Low ejection fraction (EF) value (<30%) was inclined to be associated with the decline in cognitive function. However, no significant differences were noted between heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) in cognitive scores. Conclusion BNP/NT-proBNP and the comorbidities of HF including AF, DM and anemia were inextricably correlated with CI in patients with HF, respectively. These parameters were independent factors. The severity of MTA, GM volume, BMI index, depression, sleep disorder, and low EF value (<30%) have a disposition to associated with CI. The reduction in the CBF volume may be related to CI, whereas the WM volume may not be associated with CI in HF patients. The present systematic review provides an important basis for the prevention and treatment of CI following HF.
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Affiliation(s)
- Yangyang Jiang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Lei Wang
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Ziwen Lu
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Shiqi Chen
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yu Teng
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Tong Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yang Li
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Yingzhen Xie
- Department of Encephalopathy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Mingjing Zhao
- Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
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