Cognitive frailty predicting all-cause mortality among community-living older adults in Taiwan: A 4-year nationwide population-based cohort study.

Wei-Ju Lee,Liang-Kung Chen,Li-Ning Peng,Ching-Hui Loh,Chih-Kuang Liang,Masaki Mogi

doi:10.1371/journal.pone.0200447

Abstract

BackgroundCognitive frailty (CF) featured as frailty plus cognitive impairment was deemed to be a novel target for dementia and disable prevention. The study was intended to investigate the epidemiology of CF and the association between CF and all-cause mortality.MethodsThe national representative cohort study was comprised of 1,103 community-living middle-aged and older adults. CF was defined as the co-existence of dynapenia (weakness and/or slowness) and cognitive impairment (1.5 standard deviations below the age-, sex- and education-matched norms in cognitive tests) without known neurodegenerative diseases. Dynapenia was defined by the Asian Working Group for Sarcopenia and cognitive function was assessed by the Short Portable Mental Status Questionnaire.ResultsThe prevalence of CF was 8.6% in this study. Subjects with CF were older, more likely to be women, having less regular exercise, fewer educational years, more depressive symptoms and greater multimorbidity. Compared to robust individuals, CF was significantly associated with all-cause mortality (HR: 3.1, 95% CI:1.3–7.7, p = 0.012).ConclusionDynapenia and cognitive impairment synergistically contribute to the mortality risk for the participants in this study. Further study is needed to explore the underlying pathophysiology and the reversibility of CF.

Highlights

The concept of cognitive frailty (CF) was firstly proposed by Panza, et al, in 2006 to capture a complex phenotype of people by the concomitant presence of physical frailty and cognitive impairment for disability and dementia prevention [1]
Dynapenia was defined by the Asian Working Group for Sarcopenia and cognitive function was assessed by the Short Portable Mental Status Questionnaire
Cognitive frailty (CF) was significantly associated with all-cause mortality (HR: 3.1, 95% CI:1.3–7.7, p = 0.012)

Summary

Introduction

The concept of cognitive frailty (CF) was firstly proposed by Panza, et al, in 2006 to capture a complex phenotype of people by the concomitant presence of physical frailty and cognitive impairment for disability and dementia prevention [1]. The consensus from International Academy on Nutrition and Aging (I.A.N.A) and the International Association of Gerontology and Geriatrics (I.A.G.G) proposed the operational definition of CF as the co-existence of physical frailty (defined by Fried’s criteria) and mild cognitive impairment (Clinical Dementia Rating (CDR) scale = 0.5), and without dementia, and other neurodegenerative diseases [2]. The prevalence of CF defined by IANA/IAGG criteria was low, ranged from 1.2% to 1.8, which could not identify meaningful numbers for intervention [3]. Cognitive frailty (CF) featured as frailty plus cognitive impairment was deemed to be a novel target for dementia and disable prevention. The study was intended to investigate the epidemiology of CF and the association between CF and all-cause mortality

Objectives

Methods

Conclusion