TY - JOUR
T1 - Reversible Cognitive Frailty, Dementia, and All-Cause Mortality. The Italian Longitudinal Study on Aging
AU - Solfrizzi, Vincenzo
AU - Scafato, Emanuele
AU - Seripa, Davide
AU - Lozupone, Madia
AU - Imbimbo, Bruno P.
AU - D'Amato, Angela
AU - Tortelli, Rosanna
AU - Schilardi, Andrea
AU - Galluzzo, Lucia
AU - Gandin, Claudia
AU - Baldereschi, Marzia
AU - Di Carlo, Antonio
AU - Inzitari, Domenico
AU - Daniele, Antonio
AU - Sabbà, Carlo
AU - Logroscino, Giancarlo
AU - Panza, Francesco
AU - Cacciatore, Francesco
AU - Rengo, Franco
AU - Italian Longitudinal Study on Aging Working Group
N1 - Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
PY - 2017/1
Y1 - 2017/1
N2 - OBJECTIVES: 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.DESIGN: Longitudinal population-based study with 3.5- and 7-year of median follow-up.SETTING: Eight Italian municipalities included in the Italian Longitudinal Study on Aging.PARTICIPANTS: In 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.MEASUREMENTS: Incidence of dementia, its subtypes, and all-cause mortality.RESULTS: Over 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.CONCLUSIONS: A 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.
AB - OBJECTIVES: 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.DESIGN: Longitudinal population-based study with 3.5- and 7-year of median follow-up.SETTING: Eight Italian municipalities included in the Italian Longitudinal Study on Aging.PARTICIPANTS: In 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.MEASUREMENTS: Incidence of dementia, its subtypes, and all-cause mortality.RESULTS: Over 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.CONCLUSIONS: A 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.
KW - Journal Article
U2 - 10.1016/j.jamda.2016.10.012
DO - 10.1016/j.jamda.2016.10.012
M3 - Article
C2 - 28012505
VL - 18
SP - 89.e1-89.e8
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
SN - 1525-8610
IS - 1
ER -