Reversible Cognitive Frailty, Dementia, and All-Cause Mortality. The Italian Longitudinal Study on Aging

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• 作者：Vincenzo Solfrizzi ; MD ; PhD^a ; ^&dagger ; ; Emanuele Scafato ; MD^b ; Davide Seripa ; PhD^c ; Madia Lozupone ; MD^d ; Bruno P. Imbimbo ; PhD^e ; Angela D'Amato ; MD^a ; Rosanna Tortelli ; MD^d ; Andrea Schilardi ; MD^a ; Lucia Galluzzo ; MD^b ; Claudia Gandin ; MD^b ; Marzia Baldereschi ; MD^f ; Antonio Di Carlo ; MD^f ; Domenico Inzitari ; MD^f ; ^g ; Antonio Daniele ; MD ; PhD^h ; Carlo Sabbà ; MD^a ; Giancarlo Logroscino ; MD ; PhD^d ; ⁱ ; Francesco Panza ; MD ; PhD^c ; ^d ; ⁱ ; ^&dagger ; ; ^{geriat.dot@geriatria.uniba.it} ; on behalf of the Italian Longitudinal Study on Aging Working Group^&Dagger ; ; Emanuele Scafato ; MD (Scientific Coordinator) ; Gino Farchi ; MSc ; Lucia Galluzzo ; MA ; Claudia Gandin ; MD ; Antonio Capurso ; MD ; Francesco Panza ; MD ; PhD ; Vincenzo Solfrizzi ; MD ; PhD ; Vito Lepore ; MD ; Paolo Livrea ; MD ; Luciano Motta ; MD ; Giuseppe Carnazzo ; MD ; Massimo Motta ; MD ; Prospera Bentivegna ; MD ; Salvatore Bonaiuto ; MD ; Guido Cruciani ; MD ; Demetrio Postacchini ; MD ; Domenico Inzitari ; MD ; Luigi Amaducci ; MD ; Antonio Di Carlo ; MD ; Marzia Baldereschi ; MD ; Carlo Gandolfo ; MD ; Massimo Conti ; MD ; Nicola Canal ; MD ; Massimo Franceschi ; MD ; Guglielmo Scarlato ; MD ; Livia Candelise ; MD ; Elio Scapini ; MD ; Franco Rengo ; MD ; Pasquale Abete ; MD ; Francesco Cacciatore ; MD ; Giuliano Enzi ; MD ; Leontino Battistin ; MD ; Giuseppe Sergi ; MD ; Gaetano Crepaldi ; MD ; Stefania Maggi ; MD ; Nadia Minicuci ; MD ; Marianna Noale ; MD ; Francesco Grigoletto ; ScD ; Egle Perissinotto ; ScD ; Pierugo Carbonin ; MD
• 关键词：Frailty ; cognitive aging ; vascular dementia ; Alzheimer disease ; dementia ; mortality
• 刊名：Journal of the American Medical Directors Association
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：18
• 期：1
• 页码：89.e1-89.e8
• 全文大小：577 K
• 卷排序：18

文摘

Cognitive frailty, a condition describing the simultaneous presence of physical frailty and mild cognitive impairment, has been recently defined by an international consensus group. We estimated the predictive role of a “reversible” cognitive frailty model on incident dementia, its subtypes, and all-cause mortality in nondemented older individuals. We verified if vascular risk factors or depressive symptoms could modify this predictive role.DesignLongitudinal population-based study with 3.5- and 7-year of median follow-up.SettingEight Italian municipalities included in the Italian Longitudinal Study on Aging.ParticipantsIn 2150 older individuals from the Italian Longitudinal Study on Aging, we operationalized reversible cognitive frailty with the presence of physical frailty and pre-mild cognitive impairment subjective cognitive decline, diagnosed with a self-report measure based on item 14 of the Geriatric Depression Scale.MeasurementsIncidence of dementia, its subtypes, and all-cause mortality.ResultsOver a 3.5-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia [hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.02–5.18], particularly vascular dementia (VaD), and all-cause mortality (HR 1.74, 95% CI 1.07–2.83). Over a 7-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia (HR 2.12, 95% CI 1.12–4.03), particularly VaD, and all-cause mortality (HR 1.39, 95% CI 1.03–2.00). Vascular risk factors and depressive symptoms did not have any effect modifier on the relationship between reversible cognitive frailty and incident dementia and all-cause mortality.ConclusionsA model of reversible cognitive frailty was a short- and long-term predictor of all-cause mortality and overall dementia, particularly VaD. The absence of vascular risk factors and depressive symptoms did not modify the predictive role of reversible cognitive frailty on these outcomes.