Abstract
Objective
To investigate if understated cognitive impairment existed in individuals with physical
frail or earlier prefrail state but without cognitive complaints and the susceptible
cognitive domains to the physical frailty.
Design
A cross-sectional population-based community study.
Setting
I-Lan County of Taiwan.
Participants
A total of 1839 community residents aged 50 years or older in the I-Lan Longitudinal
Aging Study.
Intervention
None.
Measurements
Frail status assessments by the Cardiovascular Health Study (CHS) criteria and a series
of neuropsychiatric assessments, including the Mini-Mental State Examination (MMSE),
the delay free recall in the Chinese Version Verbal Learning Test (CVVLT), the Boston
Naming Test (BNT), the category (animal) Verbal Fluency Test (VFT), the Taylor Complex
Figure Test (CFT), the digital backward (DB), and the Clock Drawing Test.
Results
After excluding those with significant global cognitive impairment, subjective cognitive
complaints, or functional impairment, 1686 persons aged 50 to 89 years (mean 63.4 ± 8.9)
were enrolled. The prevalence of prefrail and frail individuals was 40.2% and 4.9%,
respectively. The prefrail and frail persons had significantly poorer performance
in the MMSE and all neuropsychological tests. Slowness and weakness were the most
significant frailty components associated with cognitive impairment. The prefrail
and frail individuals showed a more dose-dependent risk for 1 or more cognitive domain
impairments than the robust individuals (odds ratio [OR] 1.28 in prefrail individuals
versus OR 1.79 in frail individuals). The susceptible cognitive domains in the prefrail
state were mainly focused on the nonmemory domains. However, the frail individuals
were more likely to have risks for impairment in both memory and nonmemory domains.
Conclusions
Even without subjective cognitive complaints, higher risk of cognitive impairment
is presented in the prefrail and frail individuals. The incremental impact of frailty
on cognition and the susceptibility of nonmemory domain may provide a new view in
evaluating the pathogenesis of the relationship between frailty and cognitive impairment.
Keywords
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Article info
Publication history
Published online: August 25, 2015
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
