Impact of Cognitive Frailty on Daily Activities in Older Persons - PubMed (original) (raw)

doi: 10.1007/s12603-016-0685-2.

H Makizako, S Lee, T Doi, S Lee, K Tsutsumimoto, K Harada, R Hotta, S Bae, S Nakakubo, K Harada, T Suzuki

Affiliations

Impact of Cognitive Frailty on Daily Activities in Older Persons

H Shimada et al. J Nutr Health Aging. 2016.

Abstract

Objectives: To identify the relationships between physical and/or cognitive frailty and instrumental activities of daily living (IADL) functioning in community living older persons.

Design: Cross sectional observation study.

Setting: Data extracted from the 2011-2013 of the National Center for Geriatrics and Gerontology-Study of Geriatric Syndromes (NCGG-SGS) database.

Participants: A total of 8,864 older adults aged ≥ 65 years who were enrolled in the NCGG-SGS.

Measurements: We characterized physical frailty as limitations in three or more of the following five domains: slow walking speed, muscle weakness, exhaustion, low activity and weight loss. To screen for cognitive impairment, we used the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT) which included tests of word list memory, attention and executive function (tablet version of the Trail Making Test, part A and B), and processing speed (tablet version of the Digit Symbol Substitution Test). Two or more cognitive impairments indicated by an age-adjusted score of at least 1.5 standard deviations below the reference threshold was characterized as cognitive impairment. Each participant reported on their IADL status (use of public transportation, shopping, management of finances, and housekeeping) and several potential confounders such as demographic characteristics.

Results: The overall prevalence of physical frailty, cognitive impairment, and cognitive frailty, i.e. co-occurrence of frailty and cognitive impairment, was 7.2%, 5.2%, and 1.2%, respectively. We found significant relationships between IADL limitations and physical frailty (Odds Ratio (OR) 1.24, 95% confidence interval (95% CI) 1.01 to 1.52), cognitive impairment (OR 1.71, 95% CI 1.39 to 2.11), and cognitive frailty (OR 2.63, 95% CI 1.74 to 3.97).

Conclusion: Using the NCGG-SGS frailty criteria, we found more participants with physical frailty than with cognitive frailty. The individuals with cognitive frailty had the highest risks of IADL limitations. Future investigation is necessary to determine whether this population is at increased risk for incidence of disability or mortality.

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Figures

Figure 1

Figure 1

Odds ratios for instrumental activities of daily living limitations according to cognitive frailty status

References

    1. World Health Organization. World report on disability. WHO Press, Geneva, 2011
    1. Boyd CM, Xue QL, Simpson CF, Guralnik JM, Fried LP. Frailty, hospitalization, and progression of disability in a cohort of disabled older women. Am J Med. 2005;118:1225–1231. 10.1016/j.amjmed.2005.01.062 PubMed PMID: 16271906. - DOI - PubMed
    1. Al Snih S, GrahAm JE, Ray LA, Samper-Ternent R, Markides KS, Ottenbacher KJ. Frailty and incidence of activities of daily living disability among older Mexican Americans. J Rehabil Med. 2009;41:892–897. 10.2340/16501977-0424 PubMed PMID: 19841840, PMCID 2795390. - DOI - PMC - PubMed
    1. Ensrud KE, Ewing SK, Cawthon PM, Fink HA, Taylor BC, Cauley JA, Dam TT, Marshall LM, Orwoll ES, Cummings SR, et al. A comparison of frailty indexes for the prediction of falls, disability, fractures, and mortality in older men. J Am Geriatr Soc. 2009;57:492–498. 10.1111/j.1532-5415.2009.02137.x PubMed PMID: 19245414, PMCID 2861353. - DOI - PMC - PubMed
    1. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56:M146–M156. 10.1093/gerona/56.3.M146 PubMed PMID: 11253156. - DOI - PubMed

Uncited references

    1. Launer LJ, Andersen K, Dewey ME, Letenneur L, Ott A, Amaducci LA, Brayne C, Copeland JR, Dartigues JF, Kragh-Sorensen P, et al. Rates and risk factors for dementia and Alzheimer’s disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of Dementia. Neurology. 1999;52:78–84. - PubMed
    1. Stern Y. Cognitive reserve and Alzheimer disease. Alzheimer Dis Assoc Disord. 2006;20:112–117. 10.1097/01.wad.0000213815.20177.19 PubMed PMID: 16772747. - DOI - PubMed
    1. Kemppainen NM, Aalto S, Karrasch M, Nagren K, Savisto N, Oikonen V, Viitanen M, Parkkola R, Rinne JO. Cognitive reserve hypothesis: Pittsburgh Compound B and fluorodeoxyglucose positron emission tomography in relation to education in mild Alzheimer’s disease. Ann Neurol. 2008;63:112–118. 10.1002/ana.21212 PubMed PMID: 18023012. - DOI - PubMed

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