Additive Role of a Potentially Reversible Cognitive Frailty Model and Inflammatory State on the Risk of Disability: The Italian Longitudinal Study on Aging

• Published in: The American journal of geriatric psychiatry Vol. 25; no. 11; p. 1236
• Main Authors: Solfrizzi, Vincenzo, Scafato, Emanuele, Lozupone, Madia, Seripa, Davide, Giannini, Michele, Sardone, Rodolfo, Bonfiglio, Caterina, Abbrescia, Daniela I, Galluzzo, Lucia, Gandin, Claudia, Baldereschi, Marzia, Di Carlo, Antonio, Inzitari, Domenico, Daniele, Antonio, Sabbà, Carlo, Logroscino, Giancarlo, Panza, Francesco
• Format: Journal Article
• Language: English
• Published: England 01.11.2017
• Subjects: Aged; Aged, 80 and over; Aging - physiology; Cognitive Dysfunction - epidemiology; Comorbidity; Disabled Persons - statistics & numerical data; Female; Follow-Up Studies; Frail Elderly - statistics & numerical data; Frailty - classification; Frailty - epidemiology; Humans; Inflammation - epidemiology; Italy - epidemiology; Longitudinal Studies; Male; Prevalence; Risk; Frailty; Alzheimer disease; inflammation; cognitive aging; disablement process; lifestyle
• ISSN: 1545-7214
• DOI: 10.1016/j.jagp.2017.05.018

Cognitive frailty is a condition recently defined by operationalized criteria describing the simultaneous presence of physical frailty and mild cognitive impairment (MCI). Two subtypes for this clinical construct have been proposed: "potentially reversible" cognitive frailty (physical frailty plus MCI) and "reversible" cognitive frailty (physical frailty plus pre-MCI subjective cognitive decline). Here the prevalence of a potentially reversible cognitive frailty model was estimated. It was also evaluated if introducing a diagnosis of MCI in older subjects with physical frailty could have an additive role on the risk of dementia, disability, and all-cause mortality in comparison with frailty state or MCI condition alone, with analyses separately performed for inflammatory state. In 2,373 individuals from the population-based Italian Longitudinal Study on Aging with a 3.5-year-follow-up, we operationally categorized older individuals without dementia into four groups: non-frail/non-MCI, non-frail/MCI, frail/non-MCI, and frail/MCI. The prevalence of potentially reversible cognitive frailty was 1%, increasing with age and more represented in women than in men, and all groups were associated with significant increased incident rate ratios of dementia, disability, and mortality. A significant difference in rates of disability has been found between the MCI and non-MCI groups (contrasts of adjusted predictions: 0.461; 95% confidence interval: 0.187-0.735) in frail individuals with high inflammatory states (fibrinogen >339 mg/dL). In older individuals without dementia and with elevated inflammation, a potentially reversible cognitive frailty model could have a significant additional predictive effect on the risk of disability than the single conditions of frailty or MCI.