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J Am Med Dir Assoc. 2017 Sep 1;18(9):785-790. doi: 10.1016/j.jamda.2017.04.008. Epub 2017 Jun 13.

Cognitive Performance across 3 Frailty Phenotypes: Toledo Study for Healthy Aging.

Author information

1
Hospital Virgen del Valle, Complejo Hospitalario de Toledo and CIBER of Frailty and Aging (CIBERFES), Toledo, Spain.
2
Fundación para la Investigación Biomédica, Hospital Universitario de Getafe, Madrid, Spain.
3
Hospital Virgen del Valle, Complejo Hospitalario de Toledo and CIBER of Frailty and Aging (CIBERFES), Toledo, Spain; Human Performance, ImFINE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Sciences-INEF, Technical University of Madrid, Madrid, Spain.
4
Servicio de Epidemiología, Dirección General de Salud Pública de Castilla-La Mancha, Toledo, Spain.
5
Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid/IdiPaz and CIBERESP, Madrid, Spain.
6
Hospital Universitario de Getafe, Madrid, Spain.
7
Hospital Virgen del Valle, Complejo Hospitalario de Toledo and CIBER of Frailty and Aging (CIBERFES), Toledo, Spain. Electronic address: franjogarcia@telefonica.net.

Abstract

INTRODUCTION:

Frailty is a strong predictor of adverse health events, but its impact on cognitive function is poorly understood.

AIM:

To assess cognitive performance in frailty and to identify the frailty stage where cognitive impairment begins.

METHODS:

Data were taken from 2044 people aged ≥65 years without cognitive impairment selected from the Toledo Study for Healthy Aging, a population-based cohort of older adults. Frailty status was assessed by 3 different scales: Frailty Phenotype (FP), Frailty Trait Scale (FTS), and Frailty Index (FI). Neuropsychological assessments of different cognitive domains included the Mini-Mental State Examination, Short and Long-Term Memory Recalling Test, the Boston Naming Test, Verbal Fluency Test, Digit Span Forward, Go/No-go Test, Luria Orders Test, Clock Drawing Test, and Serial Word Learning Test. The relationships between the score of the scales and frailty status (robust, prefrail, and frail for FP and quartiles for FTS and FI) were analyzed using multivariate linear regression models including age, sex, and educative level as possible confounders.

RESULTS:

Participants classified as the worst degree of frailty (frail in FP and fourth quartile of FTS and FI) presented more cognitive domains affected and to a higher extent than moderate frail (prefrail and second quartile and third quartile of FTS and FI) and robust (and first quartile of FTS and FI) participants.

CONCLUSIONS:

Cognitive performance progressively declined across the frailty state, regardless of the instrument used to assess frailty. In prefrail participants, cognitive impairment may be an early marker of frailty-dependent cerebral involvement and could be already subject to interventions aimed at reducing the transition to frailty.

KEYWORDS:

Frailty; cognitive domains; elderly; frailty scales

PMID:
28623151
DOI:
10.1016/j.jamda.2017.04.008
[Indexed for MEDLINE]

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