Cognitive Frailty and Adverse Health Outcomes: Findings From the Singapore Longitudinal Ageing Studies (SLAS)
Cognitive Frailty and Adverse Health Outcomes: Findings From the Singapore Longitudinal Ageing Studies (SLAS)
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DOI：
10.1016/j.jamda.2016.09.015
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发表时间：
2017-03-01
影响因子：
7.6
通讯作者：
Ng, Tze-Pin
中科院分区：
文献类型：
--
作者：
Feng, Liang;Nyunt, Ma Shwe Zin;Ng, Tze-Pin
目的：最近有一个共识的建议，“认知脆弱”的定义是存在身体虚弱和认知障碍，而没有痴呆症。然而，认知缺陷的相关性、有效性和利用率目前尚不清楚。我们确定是否并发身体虚弱和认知障碍，与单独的身体虚弱相比，大大增加了不良的健康结果设计：纵向研究。设置：以人群为基础的队列（新加坡纵向老龄化研究，SLAS）。2375名年龄在55岁及以上的新加坡华人，没有痴呆症和退行性疾病。（心血管健康研究标准：0 =健壮，1-2 =虚弱前期，3-5 =虚弱）伴和不伴认知障碍（简易精神状态检查< 26）和不良结果进行了估计，控制年龄，性别，教育，合并症，吸烟，饮酒，抑郁症状，结果：与健康的非认知功能障碍个体相比，伴有认知功能障碍的身体虚弱前患者的功能障碍患病率和发生率增加了一倍，生活质量差的发生率增加了一倍，死亡风险增加了1.8倍。认知功能受损的体弱者的功能障碍患病率和发生率增加了12至13倍，低生活质量的患病率和发生率增加了5至27倍，死亡风险增加了5倍。躯体虚弱伴认知功能障碍的患病率为1.8%，躯体虚弱前伴认知功能障碍的患病率为8.9%。结论：躯体虚弱前和躯体虚弱伴认知功能障碍的患病率为10.7%，与不良健康后果的发生率显著相关。(C)2016年AMDA -急性后和长期护理医学协会。这是一个CC BY-NC-ND许可下的开放获取文章。
Objectives: There is a recent consensus proposal of "cognitive frailty" defined by the presence of both physical frailty and cognitive impairment in the absence of dementia. The relevance, validity, and utilization of cognitive frailty, however, is presently unclear. We determine whether concurrent physical frailty and cognitive impairment, compared with physical frailty alone substantially increased adverse health outcomes (functional disability, hospitalization, poor quality of life [QOL], and mortality).Design: Longitudinal study.Setting: Population-based cohort (Singapore Longitudinal Ageing Study, SLAS).Participants: Two thousand three hundred seventy-five Chinese Singaporeans aged 55 and above without dementia and degenerative disorders.Measurements: The associations of physical frailty (Cardio vascular Health Study criteria: 0 = robust, 1-2 = prefrail, 3-5 = frail) with and without cognitive impairment (mini-mental state examination < 26) and adverse outcomes were estimated, controlling for age, gender, education, comorbidity, smoking, alcohol consumption, depressive symptoms, baseline activities of daily living-instrumental and basic activities of daily living disability or QOL score.Results: Compared to robust noncognitively impaired individuals, physical pre-frailty with cognitive impairment was associated with a twofold increased prevalence and incidence of functional disability, a twofold increased incidence of poor QOL, and 1.8-fold increased mortality risks. Cognitively impaired frail individuals stood out with 12- to 13-fold increased prevalence and incidence of functional disability, a five-and 27-fold increased prevalence and incidence of low QOL, and a fivefold increased mortality risk. The estimated prevalence of physical frailty with cognitive impairment was 1.8%, and physical pre-frailty with cognitive impairment was 8.9%.Conclusion: Pre-frailty and frailty with impaired cognitive function, found in 10.7% of this dementia-free population, was associated with an evidently high risk of adverse health outcomes. (C) 2016 AMDA - The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY-NC-ND license.