Frailty Index and Cognitive Decline in Alzheimer's Disease: Data from the Impact of Cholinergic Treatment USe Study
Frailty Index and Cognitive Decline in Alzheimer's Disease: Data from the Impact of Cholinergic Treatment USe Study
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DOI：
10.1111/jgs.13956
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发表时间：
2016-06-01
影响因子：
6.3
通讯作者：
Cesari, Matteo
中科院分区：
文献类型：
--
作者：
Kelaiditi, Eirini;Canevelli, Marco;Cesari, Matteo
目的：确定虚弱指数（FI）是否与短期认知能力下降相关（根据简易精神状态检查量表（MMSE）和阿尔茨海默病评估量表-认知子量表的变化设计：前瞻性队列研究。背景：胆碱能治疗的影响研究。参与者：患有轻度至中度AD的个体（N = 973）。测量：使用临床痴呆评定（CDR）评估痴呆的严重程度。FI计算为实际赤字与潜在赤字的比率（现有赤字除以30）。进行线性回归分析，并根据痴呆的严重程度分层。校正年龄、性别和受教育年限后，FI增加0.033分对应于显著和临床相关的认知下降，（MMSE评分为0.63-4.63分，P =.01; ADAS-Cog评分为2.87-11.1分，P =.001）。非虚弱和虚弱个体之间MMSE和ADAS-Cog评分变化的差异分别为0.67和1.6分。尽管具有统计学意义，但这一发现的临床相关性仍有待进一步研究。结论：FI可能是评估AD患者易感性的一种有前途的工具。它在临床实践中的实施可以通过识别具有高风险的负面结果，特别是短期认知能力下降的个体来支持临床决策。
OBJECTIVES: To determine whether the Frailty Index (FI) was associated with short-term cognitive decline (according to changes in Mini Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) scores at 1-year follow-up) in individuals with Alzheimer's disease (AD).DESIGN: Prospective cohort study.SETTING: Impact of Cholinergic Treatment USe study.PARTICIPANTS: Individuals with mild-to-moderate AD (N = 973).MEASUREMENTS: Severity of dementia was assessed using the Clinical Dementia Rating (CDR). FI was calculated as the ratio of actual to potential deficits (deficits present divided by 30). Linear regression analyses were performed and stratified according to severity of dementia.RESULTS: A 1-unit (0.033 points) increase in FI corresponded to significant and clinically relevant cognitive decline, after adjustments for age, sex, and years of education (0.63-4.63 points on the MMSE, P =.01; 2.87-11.1 points on the ADAS-Cog, P =.001) after 1 year of followup. Differences in changes in MMSE and ADAS-Cog scores between nonfrail and frail individuals were 0.67 and 1.6 points, respectively. Although statistically significant, the clinical relevance of this finding remains to be further investigated.CONCLUSION: The FI may be a promising instrument for the assessment of the vulnerability of individuals with AD. Its implementation in clinical practice may support clinical decisions by identifying individuals at high risk of negative outcomes, specifically, short-term cognitive decline.