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

V. Solfrizzi, E. Scafato, M. Lozupone, D. Seripa, M. Giannini, R. Sardone, C. Bonfiglio, D.I. Abbrescia, L. Galluzzo, C. Gandin, M. Baldereschi, A. Di Carlo, D. Inzitari, A. Daniele, C. Sabbà, G. Logroscino, F. Panza, G. Farchi, A. Capurso, V. LeporeP. Livrea, L. Motta, G. Carnazzo, M. Motta, P. Bentivegna, S. Bonaiuto, G. Cruciani, D. Postacchini, L. Amaducci, C. Gandolfo, M. Conti, N. Canal, M. Franceschi, G. Scarlato, L. Candelise, E. Scapini, F. Rengo, P. Abete, F. Cacciatore, G. Enzi, L. Battistin, G. Sergi, G. Crepaldi, S. Maggi, N. Minicucci, M. Noale, F. Grigoletto, E. Perissinotto, P. Carbonin

Research output: Contribution to journalArticle

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. © 2017 American Association for Geriatric Psychiatry
Original languageEnglish
Pages (from-to)1236-1248
Number of pages13
JournalAmerican Journal of Geriatric Psychiatry
Volume25
Issue number11
DOIs
Publication statusPublished - 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., Farchi, G., Capurso, A., ... Carbonin, P. (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, 25(11), 1236-1248. https://doi.org/10.1016/j.jagp.2017.05.018