Abstract
The aim of this study was to examine calf circumference in relation to cognitive frailty in community-dwelling older adults. Cross-sectional analysis was performed on the first-year baseline data of 1559 adults aged 70–84 years enrolled in the Korean Frailty and Aging Cohort Study. The final analysis included 1221 adults who were non-dependent in terms of instrumental activities of daily living, who underwent frailty and cognitive function assessments. Physical frailty was defined using the Fried Frailty Index. Cognitive impairment was defined as a score 1.5 standard deviations below the age-, sex- and education-matched norms on any of four cognitive-function tests. The prevalence of cognitive frailty was 2.8% for men and 3.8% for women. After adjusting for potential confounders, in comparison to the “physically robust without cognitive impairment” group, the estimates of increased odds ratios (ORs) for low calf circumference (<32 cm) were much greater in the prefrail with cognitive impairment (OR 4.62, 95% confidence interval (CI): 2.02–10.61) and frail with cognitive impairment (OR 10.94, 95% CI: 2.87–41.68) groups in men but not in women. Low calf circumference was strongly related to cognitive frailty in men only, suggesting calf circumference can be used as an indicator of these outcomes.
Highlights
Frailty is common among people with the geriatric syndrome and results in adverse health outcomes including hospitalization, institutionalization, falls, functional disability, and mortality [1,2]
Physical frailty showed a relationship with an increased prevalence of cognitive impairment, and co-existing physical frailty and cognitive impairment conferred a greater risk of incident dementia [8]
We found a significant association between calf circumference and physical frailty in both sexes, consistent with the findings of the Aging and Longevity Study [19]
Summary
Frailty is common among people with the geriatric syndrome and results in adverse health outcomes including hospitalization, institutionalization, falls, functional disability, and mortality [1,2]. Adding cognitive impairment to the operational definition of the frail phenotype could improve its predictive validity with regard to adverse health outcomes [3]. Cognitive frailty is defined as the simultaneous presence of physical frailty and cognitive impairment [4]. In the Frailty Operative Definition Consensus Conference Project, experts agreed on the importance of a more comprehensive definition of frailty, to include both physical performance and cognition components [5]. Physical frailty showed a relationship with an increased prevalence of cognitive impairment, and co-existing physical frailty and cognitive impairment conferred a greater risk of incident dementia [8]. It is important that the tools potentially useful for identifying cognitively frail individuals capture the cognitive-frailty relationship, to inform future preventive and therapeutic strategies in older adults who may progress to dementia
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