Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study

Background: Frailty is a multidimensional concept, including physical, cognitive, social, sensorial, psychological, and nutritional phenotypes. Among these phenotypes, cognitive frailty is the most widely investigated, which is related to many adverse health outcomes in older individuals. Whether co...

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Autores principales:	Huiyu Tang, Huan Zhu, Qianqian Sun, Hai Qin, Shuang Wang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	community-living elderly cognitive frailty (CF) transitions risk factors Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/211cb2b374ac4d1084a2447d11f81edb
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spelling	oai:doaj.org-article:211cb2b374ac4d1084a2447d11f81edb2021-12-02T00:28:27ZTransitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study1663-436510.3389/fnagi.2021.774268https://doaj.org/article/211cb2b374ac4d1084a2447d11f81edb2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fnagi.2021.774268/fullhttps://doaj.org/toc/1663-4365Background: Frailty is a multidimensional concept, including physical, cognitive, social, sensorial, psychological, and nutritional phenotypes. Among these phenotypes, cognitive frailty is the most widely investigated, which is related to many adverse health outcomes in older individuals. Whether cognitive frailty is dynamic or how these frail phenotypes interact remains an open issue. We studied the rate of these changes over time and their associated factors in a 6-year follow-up cohort.Methods: A total of 426 Chinese community-living older adults in Dujiangyan aged 65 years or older were involved and followed up in three visits 6 years apart. Frailty and cognitive function were assessed using the FRAIL scale and the Mini-Mental State Examination scale. Demographic information, geriatric syndrome, and social interaction status were studied. Rates of transitions in cognitive frailty states and associated risk factors were studied. We used the stepwise logistic regression model to analyze risk factors.Results: At baseline, 18.8% of participants were only in the physical frailty (PF) or mild cognitive impairment (MCI) group, and 0.09% of participants were in the cognitive frailty group. By the end of 6 years, 62 (14.5%) participants had died, and the rates of only PF or MCI group and cognitive frailty group increased to 36.2 and 3.3%, respectively. Also, 199 (46.7%) participants had deteriorated compared with the baseline. The multivariate regression analysis showed that older (OR = 1.12, 95% CI = 1.07 − 1.16, P < 0.001), smoker (OR = 2.15, 95% CI = 1.37 − 3.39, P = 0.001), poor self-evaluation health status (OR = 1.93, 95% CI = 1.06 − 3.51, P = 0.033), and malnutrition (OR = 2.07, 95% CI = 1.21 − 3.52, P = 0.008) were risk factors for worsening, whereas willing to make new friends (OR = 0.61, 95% CI = 0.38 − 0.96, P = 0.032) was associated with 39% lower chance of deterioration.Conclusion: Cognitive frailty is a dynamically changing state, where transitions may be influenced by multidimensions. Multidimensional monitoring of a wide range of events occurring in aging may be the best way to act early. We hope our study may serve as a starting point for redefining the definition of cognitive frailty by covering different frailty domains.Huiyu TangHuan ZhuQianqian SunHai QinShuang WangFrontiers Media S.A.articlecommunity-livingelderlycognitive frailty (CF)transitionsrisk factorsNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENFrontiers in Aging Neuroscience, Vol 13 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	community-living elderly cognitive frailty (CF) transitions risk factors Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	community-living elderly cognitive frailty (CF) transitions risk factors Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Huiyu Tang Huan Zhu Qianqian Sun Hai Qin Shuang Wang Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study
description	Background: Frailty is a multidimensional concept, including physical, cognitive, social, sensorial, psychological, and nutritional phenotypes. Among these phenotypes, cognitive frailty is the most widely investigated, which is related to many adverse health outcomes in older individuals. Whether cognitive frailty is dynamic or how these frail phenotypes interact remains an open issue. We studied the rate of these changes over time and their associated factors in a 6-year follow-up cohort.Methods: A total of 426 Chinese community-living older adults in Dujiangyan aged 65 years or older were involved and followed up in three visits 6 years apart. Frailty and cognitive function were assessed using the FRAIL scale and the Mini-Mental State Examination scale. Demographic information, geriatric syndrome, and social interaction status were studied. Rates of transitions in cognitive frailty states and associated risk factors were studied. We used the stepwise logistic regression model to analyze risk factors.Results: At baseline, 18.8% of participants were only in the physical frailty (PF) or mild cognitive impairment (MCI) group, and 0.09% of participants were in the cognitive frailty group. By the end of 6 years, 62 (14.5%) participants had died, and the rates of only PF or MCI group and cognitive frailty group increased to 36.2 and 3.3%, respectively. Also, 199 (46.7%) participants had deteriorated compared with the baseline. The multivariate regression analysis showed that older (OR = 1.12, 95% CI = 1.07 − 1.16, P < 0.001), smoker (OR = 2.15, 95% CI = 1.37 − 3.39, P = 0.001), poor self-evaluation health status (OR = 1.93, 95% CI = 1.06 − 3.51, P = 0.033), and malnutrition (OR = 2.07, 95% CI = 1.21 − 3.52, P = 0.008) were risk factors for worsening, whereas willing to make new friends (OR = 0.61, 95% CI = 0.38 − 0.96, P = 0.032) was associated with 39% lower chance of deterioration.Conclusion: Cognitive frailty is a dynamically changing state, where transitions may be influenced by multidimensions. Multidimensional monitoring of a wide range of events occurring in aging may be the best way to act early. We hope our study may serve as a starting point for redefining the definition of cognitive frailty by covering different frailty domains.
format	article
author	Huiyu Tang Huan Zhu Qianqian Sun Hai Qin Shuang Wang
author_facet	Huiyu Tang Huan Zhu Qianqian Sun Hai Qin Shuang Wang
author_sort	Huiyu Tang
title	Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study
title_short	Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study
title_full	Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study
title_fullStr	Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study
title_full_unstemmed	Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study
title_sort	transitions in the cognitive frailty states in community-living older adults: a 6-year prospective cohort study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/211cb2b374ac4d1084a2447d11f81edb
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Transitions in the Cognitive Frailty States in Community-Living Older Adults: A 6-Year Prospective Cohort Study

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