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

Vincenzo Solfrizzi, Emanuele Scafato, Madia Lozupone, Davide Seripa, Michele Giannini, Rodolfo Sardone, Caterina Bonfiglio, Daniela I Abbrescia, Lucia Galluzzo, Claudia Gandin, Marzia Baldereschi, Antonio Di Carlo, Domenico Inzitari, Antonio Daniele, Carlo Sabbà, Giancarlo Logroscino, Francesco Panza, Italian Longitudinal Study on Aging Working Group

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Abstract

OBJECTIVE: 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.

METHODS: 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.

RESULTS: 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).

CONCLUSION: 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.

Original languageEnglish
JournalAmerican Journal of Geriatric Psychiatry
DOIs
Publication statusE-pub ahead of print - Jul 6 2017

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Solfrizzi, V., Scafato, E., Lozupone, M., Seripa, D., Giannini, M., Sardone, R., Bonfiglio, C., Abbrescia, D. I., Galluzzo, L., Gandin, C., Baldereschi, M., Di Carlo, A., Inzitari, D., Daniele, A., Sabbà, C., Logroscino, G., Panza, F., & Italian Longitudinal Study on Aging Working Group (2017). Additive Role of a Potentially Reversible Cognitive Frailty Model and Inflammatory State on the Risk of Disability: The Italian Longitudinal Study on Aging. American Journal of Geriatric Psychiatry. https://doi.org/10.1016/j.jagp.2017.05.018