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The journal of nutrition, health & aging

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01-05-2020 | Malnutrition

Prevalence and Its Associated Factors of Physical Frailty and Cognitive Impairment: Findings from the West China Health and Aging Trend Study (WCHAT)

Authors: M. Ge, Y. Zhang, W. Zhao, J. Yue, L. Hou, X. Xia, Y. Zhao, X. Liu, Birong Dong, Ning Ge

Published in: The journal of nutrition, health & aging | Issue 5/2020

Abstract

Objectives

Previous literature has reported that physical frailty (PF) closely associated with cognitive impairment (CI). In this study, we aim to describe and evaluate the prevalence and associated factors with different patterns of PF and cognitive impairment.

Design

A cross-sectional study.

Setting and participants

Community-dwelling older adults aged ≥60 from the West China Health and Aging Trend (WCHAT) study were included in this study.

Measurements

Participants were assessed the PF and cognitive impairment. PF was assessed using the physical phenotype as defined by Fried’s criteria. Cognitive impairment was identified using the Short Portable Mental Status Questionnaire (SPMSQ). According different patterns of PF and cognitive impairment, participants were divided into 4 groups: not-PF and cognitive intact (“neither” group), not-PF and cognitive impairment (“CI only” group), PF and cognitive intact (“PF only” group), and PF and cognitive impairment (“both” group). Multinomial logistic regression was used to explore the association between medical conditions and different patterns of PF and cognitive impairment after adjusting the demographic characteristics.

Results

Among 4,103 participants (age 67.8 ± 5.9 years, female 58.3%), 78.8%, 3.9%, 14.5% and 2.9% were “neither”, “PF only”, “CI only”, and “both”, respectively. The prevalence of “PF only”, “CI only” and “both” were associated with age, lower education level and single status. In addition, there was substantial ethnicity heterogeneity in the prevalence of different patterns of PF and cognitive impairment. Comparing with “neither”, PF and/or cognitive impairment had higher association with depression, ADLs impairment, and malnutrition. Of note, obesity was only significantly associated with “PF only”, but not associated with “CI only” or “both”.

Conclusions

We found the substantial demographic and medical conditions disparities in different patterns of PF and cognitive impairment. Further research should focus on the efficient and practical screen to predict the risk of “PF only”, “CI only” and “both”.

Xue QL. The frailty syndrome: definition and natural history. Clinics in geriatric medicine 2011;27(1):1–15. doi:https://doi.org/10.1016/j.cger.2010.08.009 PubMedPubMedCentral

Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA, Cardiovascular Health Study Collaborative Research G. Frailty in older adults: evidence for a phenotype. The journals of gerontology Series A, Biological sciences and medical sciences 2001;56(3):M146–156PubMed

Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet (London, England) 2013;381(9868):752–762. doi: 10.1016/s0140-6736(12)62167-9

Wu C, Smit E, Xue QL, Odden MC. Prevalence and Correlates of Frailty Among Community-Dwelling Chinese Older Adults: The China Health and Retirement Longitudinal Study. The journals of gerontology Series A, Biological sciences and medical sciences 2017;73(1):102–108. doi:https://doi.org/10.1093/gerona/glx098 PubMedPubMedCentral

Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and Management of Dementia: Review. Jama 2019;322(16):1589–1599. doi:https://doi.org/10.1001/jama.2019.4782 PubMed

The L. Bringing frailty into all realms of medicine. Lancet (London, England) 2019;394(10206):1298. doi:https://doi.org/10.1016/s0140-6736(19)32279-2

Robertson DA, Savva GM, Coen RF, Kenny RA. Cognitive function in the prefrailty and frailty syndrome. Journal of the American Geriatrics Society 2014;62(11):2118–2124. doi:https://doi.org/10.1111/jgs.13111 PubMed

Chen S, Honda T, Narazaki K, Chen T, Nofuji Y, Kumagai S. Global cognitive performance and frailty in non-demented community-dwelling older adults: Findings from the Sasaguri Genkimon Study. Geriatrics & gerontology international 2016;16(6):729–736. doi:https://doi.org/10.1111/ggi.12546

Kiiti Borges M, Oiring de Castro Cezar N, Silva Santos Siqueira A, Yassuda M, Cesari M, Aprahamian I. The Relationship between Physical Frailty and Mild Cognitive Impairment in the Elderly: A Systematic Review. The Journal of frailty & aging 2019;8(4):192–197. doi:https://doi.org/10.14283/jfa.2019.29

10.

Fougere B, Daumas M, Lilamand M, Sourdet S, Delrieu J, Vellas B, Abellan van Kan G. Association Between Frailty and Cognitive Impairment: Cross-Sectional Data From Toulouse Frailty Day Hospital. Journal of the American Medical Directors Association 2017;18(11):990.e991-990.e995. doi:https://doi.org/10.1016/j.jamda.2017.06.024 PubMed

11.

Trebbastoni A, Canevelli M, D’Antonio F, Imbriano L, Podda L, Rendace L, Campanelli A, Celano V, Bruno G, de Lena C. The Impact of Frailty on the Risk of Conversion from Mild Cognitive Impairment to Alzheimer’s Disease: Evidences from a 5-Year Observational Study. Front Med (Lausanne) 2017;4:178. doi: 10.3389/fmed.2017.00178

12.

Chen S, Honda T, Narazaki K, Chen T, Kishimoto H, Haeuchi Y, Kumagai S. Physical Frailty Is Associated with Longitudinal Decline in Global Cognitive Function in Non-Demented Older Adults: A Prospective Study. The journal of nutrition, health & aging 2018;22(1):82–88. doi:https://doi.org/10.1007/s12603-017-0924-1

13.

Feng L, Zin Nyunt MS, Gao Q, Feng L, Yap KB, Ng TP. Cognitive Frailty and Adverse Health Outcomes: Findings From the Singapore Longitudinal Ageing Studies (SLAS). Journal of the American Medical Directors Association 2017;18(3):252–258. doi:https://doi.org/10.1016/j.jamda.2016.09.015 PubMed

14.

Grande G, Haaksma ML, Rizzuto D, Melis RTF, Marengoni A, Onder G, Weimer AK, Fratiglioni L, Vetrano DL. Co-occurrence of cognitive impairment and physical frailty, and incidence of dementia: Systematic review and meta-analysis. Neurosci Biobehav Rev 2019;107:96–103. doi:https://doi.org/10.1016/j.neubiorev.2019.09.001 PubMed

15.

Yu R, Morley JE, Kwok T, Leung J, Cheung O, Woo J. The Effects of Combinations of Cognitive Impairment and Pre-frailty on Adverse Outcomes from a Prospective Community-Based Cohort Study of Older Chinese People. Front Med (Lausanne) 2018;5:50. doi:https://doi.org/10.3389/fmed.2018.00050

16.

Downer B, Al Snih S, Howrey BT, Raji MA, Markides KS, Ottenbacher KJ. Combined effects of cognitive impairment and pre-frailty on future frailty and death in older Mexican Americans. Aging Ment Health 2018; 1–8. doi: 10.1080/13607863.2018.1493719

17.

Rockwood K, Stolee P, McDowell I. Factors associated with institutionalization of older people in Canada: testing a multifactorial definition of frailty. J Am Geriatr Soc 1996;44(5):578–582PubMed

18.

Kelaiditi E, Cesari M, Canevelli M, van Kan GA, Ousset PJ, Gillette-Guyonnet S, Ritz P, Duveau F, Soto ME, Provencher V, Nourhashemi F, Salva A, Robert P, Andrieu S, Rolland Y, Touchon J, Fitten JL, Vellas B. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. The journal of nutrition, health & aging 2013;17(9):726–734. doi: 10.1007/s12603-013-0367-2

19.

Ma L, Zhang L, Zhang Y, Li Y, Tang Z, Chan P. Cognitive Frailty in China: Results from China Comprehensive Geriatric Assessment Study. Front Med (Lausanne) 2017;4:174. doi:https://doi.org/10.3389/fmed.2017.00174

20.

Hao Q, Dong B, Yang M, Dong B, Wei Y. Frailty and Cognitive Impairment in Predicting Mortality Among Oldest-Old People. Front Aging Neurosci 2018;10:295. doi: 10.3389/fnagi.2018.00295PubMedPubMedCentral

21.

Ruan Q, Yu Z, Chen M, Bao Z, Li J, He W. Cognitive frailty, a novel target for the prevention of elderly dependency. Ageing Research Reviews 2015;20:1–10. doi:https://doi.org/10.1016/j.arr.2014.12.004 PubMed

22.

Yan-yan W, Chuan-yao D, Ding D, Yi S, Tai-ping L, Ji-rong Y, Ning G. Development and validation of the China Leisure Time Physical Activity Questionnaire in the elderly. Practical Geriatrics 2019;33(03):229–233. doi: 10:3969/j:issn: 1003:9198:2019:03:006

23.

Conway JM, Irwin ML, Ainsworth BE. Estimating energy expenditure from the Minnesota Leisure Time Physical Activity and Tecumseh Occupational Activity questionnaires — a doubly labeled water validation. Journal of clinical epidemiology 2002;55(4):392–399. doi:https://doi.org/10.1016/s0895-4356(01)00497-8 PubMed

24.

Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society 1975;23(10):433–441. doi:https://doi.org/10.1111/j.1532-5415.1975.tb00927.x PubMed

25.

Whitson HE, Malhotra R, Chan A, Matchar DB, Ostbye T. Comorbid visual and cognitive impairment: relationship with disability status and self-rated health among older Singaporeans. Asia-Pacific journal of public health 2014;26(3):310–319. doi:https://doi.org/10.1177/1010539512443698 PubMed

26.

Nazir A, LaMantia M, Chodosh J, Khan B, Campbell N, Hui S, Boustani M. Interaction between cognitive impairment and discharge destination and its effect on rehospitalization. Journal of the American Geriatrics Society 2013;61(11):1958–1963. doi:https://doi.org/10.1111/jgs.12501 PubMed

27.

Wade DT, Collin C. The Barthel ADL Index: a standard measure of physical disability? International disability studies 1988;10(2):64–67. doi:https://doi.org/10.3109/09638288809164105 PubMed

28.

Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. Journal of psychiatric research 1982;17(1):37–49. doi: 10.1016/0022-3956(82)90033-4PubMed

29.

Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). The journals of gerontology Series A, Biological sciences and medical sciences 2001;56(6):M366–372PubMed

30.

Li CL, Chang HY, Stanaway FF. Combined effects of frailty status and cognitive impairment on health-related quality of life among community dwelling older adults. Archives of gerontology and geriatrics 2019;87:103999. doi:https://doi.org/10.1016/j.archger.2019.103999 PubMed

31.

Aliberti MJR, Cenzer IS, Smith AK, Lee SJ, Yaffe K, Covinsky KE. Assessing Risk for Adverse Outcomes in Older Adults: The Need to Include Both Physical Frailty and Cognition. Journal of the American Geriatrics Society 2019;67(3):477–483. doi:https://doi.org/10.1111/jgs.15683 PubMed

32.

Yoshizawa Y, Tanaka T, Takahashi K, Fujisaki M, Iijima K. [The associations of frailty with regular participation in physical, cultural, and community social activities among independent elders in Japan]. [Ninon koshu eisei zasshi] Japanese journal of public health 2019;66(6):306–316. doi:https://doi.org/10.11236/jph.66.6_306

33.

Alhambra-Borras T, Dura-Ferrandis E, Ferrando-Garcia M. Effectiveness and Estimation of Cost-Effectiveness of a Group-Based Multicomponent Physical Exercise Programme on Risk of Falling and Frailty in Community-Dwelling Older Adults. International journal of environmental research and public health 2019;16(12). doi: 10.3390/ijerph16122086

34.

Yao L, Foley KT, Kolanowski AM, Smith BA. Proto Tai Chi: In search of a promising group exercise for the frail elderly. Geriatric nursing (New York, NY) 2014;35(2 Suppl):S21–26. doi:https://doi.org/10.1016/j.gerinurse.2014.02.021

35.

Chin APMJ, van Uffelen JG, Riphagen I, van Mechelen W. The functional effects of physical exercise training in frail older people: a systematic review. Sports medicine (Auckland, NZ) 2008;38(9):781–793. doi: 10.2165/00007256-200838090-00006

36.

Liu H. The Qiang Folk Dance: Multicultural Characteristics and Social Function. Guizhou Ethnic Studies 2015;36(173):98–101. doi:https://doi.org/10.13965/j.cnki.gzmzyj10026959.2015.07.024

37.

Chen Y, Lv C, Li X, Zhang J, Chen K, Liu Z, Li H, Fan J, Qin T, Luo L, Zhang Z. The positive impacts of early-life education on cognition, leisure activity, and brain structure in healthy aging. Aging 2019;11(14):4923–4942. doi: 10.18632/aging. 102088PubMedPubMedCentral

38.

Mukadam N, Sommerlad A, Huntley J, Livingston G. Population attributable fractions for risk factors for dementia in low-income and middle-income countries: an analysis using cross-sectional survey data. The Lancet Global health 2019;7(5):e596–e603. doi:https://doi.org/10.1016/s2214-109x(19)30074-9 PubMed

39.

Valenzuela MJ, Sachdev P. Brain reserve and cognitive decline: a non-parametric systematic review. Psychological medicine 2006;36(8):1065–1073. doi:https://doi.org/10.1017/s0033291706007744 PubMed

40.

Vaughan L, Corbin AL, Goveas JS. Depression and frailty in later life: a systematic review. Clin Interv Aging 2015;10:1947–1958. doi:https://doi.org/10.2147/cia.S69632 PubMedPubMedCentral

41.

Soysal P, Veronese N, Thompson T, Kahl KG, Fernandes BS, Prina AM, Solmi M, Schofield P, Koyanagi A, Tseng PT, Lin PY, Chu CS, Cosco TD, Cesari M, Carvalho AF, Stubbs B. Relationship between depression and frailty in older adults: A systematic review and meta-analysis. Ageing research reviews 2017;36:78–87. doi:https://doi.org/10.1016/j.arr.2017.03.005 PubMed

42.

Alexopoulos GS. Depression in the elderly. Lancet (London, England) 2005;365(9475):1961–1970. doi: 10.1016/s0140-6736(05)66665-2

43.

Heward J, Stone L, Paddick SM, Mkenda S, Gray WK, Dotchin CL, Kissima J, Collingwood C, Swai B, Walker RW. A longitudinal study of cognitive decline in rural Tanzania: rates and potentially modifiable risk factors. International psychogeriatrics 2018;30(9):1333–1343. doi:https://doi.org/10.1017/s1041610217002861 PubMed

44.

Yang X, Lupon J, Vidan MT, Ferguson C, Gastelurrutia P, Newton PJ, Macdonald PS, Bueno H, Bayes-Genis A, Woo J, Fung E. Impact of Frailty on Mortality and Hospitalization in Chronic Heart Failure: A Systematic Review and Meta-Analysis. Journal of the American Heart Association 2018;7(23):e008251. doi:https://doi.org/10.1161/jaha.117.008251 PubMedPubMedCentral

45.

Chu NM, Bandeen-Roche K, Tian J, Kasper JD, Gross AL, Carlson M, Xue QL. Hierarchical Development of Frailty and Cognitive Impairment: Clues into Etiological Pathways. The journals of gerontology Series A, Biological sciences and medical sciences, 2019. doi:https://doi.org/10.1093/gerona/glz134

Title: Prevalence and Its Associated Factors of Physical Frailty and Cognitive Impairment: Findings from the West China Health and Aging Trend Study (WCHAT)
Authors: M. Ge
Y. Zhang
W. Zhao
J. Yue
L. Hou
X. Xia
Y. Zhao
X. Liu
Birong Dong
Ning Ge
Publication date: 01-05-2020
Publisher: Springer Paris
Keyword: Malnutrition
Published in: The journal of nutrition, health & aging / Issue 5/2020
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI: https://doi.org/10.1007/s12603-020-1363-y

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Design

Setting and participants

Measurements

Results

Conclusions

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