Prevalence of frailty, cognitive impairment, and sarcopenia in outpatients with cardiometabolic disease in a frailty clinic.
Prevalence of frailty, cognitive impairment, and sarcopenia in outpatients with cardiometabolic disease in a frailty clinic.
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虚弱诊所中心脏代谢性疾病患者虚弱、认知障碍和骨质疏松症的患病率。
DOI：
10.1186/s12877-018-0955-4
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发表时间：
2018-11-06
期刊：
影响因子：
4.1
通讯作者：
Araki A
中科院分区：
文献类型：
--
作者：
Tamura Y;Ishikawa J;Fujiwara Y;Tanaka M;Kanazawa N;Chiba Y;Iizuka A;Kaito S;Tanaka J;Sugie M;Nishimura T;Kanemaru A;Shimoji K;Hirano H;Furuta K;Kitamura A;Seino S;Shinkai S;Harada K;Kyo S;Ito H;Araki A
虽然虚弱和认知障碍是老年居民一般人群残疾和死亡的关键风险因素，但这些因素在专科门诊治疗的个人中的流行率和发生率尚不清楚。我们最近建立了一个虚弱诊所，对虚弱、肌肉减少症和认知等疾病进行全面评估，并计划进行为期3年的前瞻性观察研究，以确定这些衰老相关状态进展的风险因素。到目前为止，我们招募了323名患者，他们主要来自心脏病和糖尿病专科门诊，表现出提示虚弱的症状。虚弱状态通过改良的心血管健康研究（mCHS）标准和其他一些量表进行诊断。认知功能通过简易精神状态检查（MMSE）、蒙特利尔认知评估（MoCA-J）日文版和其他一些方式进行评估。根据亚洲肌肉减少症工作组（AWGS）的标准定义肌肉减少症。在这份报告中，我们概述了我们的虚弱诊所，并分析了受试者的背景特征。大多数患者报告高血压（78%）、糖尿病（57%）或血脂异常（63%），心血管疾病和可能的心力衰竭的患病率也较高。根据mCHS标准诊断的虚弱、MMSE（≤27）和MoCA-J（≤25）定义的认知障碍以及AWG定义的肌肉减少症的患病率分别为24、41、84和31%。虚弱和认知障碍的患病率随着年龄的增长而增加，而肌肉减少症患病率的增加在80岁后达到稳定。在有和无糖尿病、高血压或血脂异常的组之间，未观察到虚弱、认知障碍和肌肉减少症的患病率存在显著差异，少数例外，推测是由于高风险受试者患有多种心血管合并症。大多数虚弱和肌肉减少的患者表现出认知障碍，而这些患者中疑似痴呆的频率均约为20%。我们发现在我们的虚弱诊所中，心脏代谢疾病患者中虚弱、认知障碍和肌肉减少症的患病率很高。对高危患者进行全面评估可能有助于确定虚弱和认知能力下降进展的危险因素。
Although frailty and cognitive impairment are critical risk factors for disability and mortality in the general population of older inhabitants, the prevalence and incidence of these factors in individuals treated in the specialty outpatient clinics are unknown. We recently established a frailty clinic for comprehensive assessments of conditions such as frailty, sarcopenia, and cognition, and planned 3-year prospective observational study to identify the risk factors for progression of these aging-related statuses. To date, we recruited 323 patients who revealed symptoms suggestive of frailty mainly from a specialty outpatient clinic of cardiology and diabetes. Frailty status was diagnosed by the modified Cardiovascular Health Study (mCHS) criteria and some other scales. Cognitive function was assessed by Mini-Mental State Examination (MMSE), Japanese version of the Montreal Cognitive Assessment (MoCA-J), and some other modalities. Sarcopenia was defined by the criteria of the Asian Working Group for Sarcopenia (AWGS). In this report, we outlined our frailty clinic and analyzed the background characteristics of the subjects. Most patients reported hypertension (78%), diabetes mellitus (57%), or dyslipidemia (63%), and cardiovascular disease and probable heart failure also had a higher prevalence. The prevalence of frailty diagnosed according to the mCHS criteria, cognitive impairment defined by MMSE (≤27) and MoCA-J (≤25), and of AWGS-defined sarcopenia were 24, 41, and 84, and 31%, respectively. The prevalence of frailty and cognitive impairment increased with aging, whereas the increase in sarcopenia prevalence plateaued after the age of 80 years. No significant differences were observed in the prevalence of frailty, cognitive impairment, and sarcopenia between the groups with and without diabetes mellitus, hypertension, or dyslipidemia with a few exceptions, presumably due to the high-risk subjects who had multiple cardiovascular comorbidities. A majority of the frail and sarcopenic patients revealed cognitive impairment, whereas the frequency of suspected dementia among these patients were both approximately 20%. We found a high prevalence of frailty, cognitive impairment, and sarcopenia in patients with cardiometabolic disease in our frailty clinic. Comprehensive assessment of the high-risk patients could be useful to identify the risk factors for progression of frailty and cognitive decline.
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