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Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies.
J Gerontol A Biol Sci Med Sci. 2017 03 01; 72(3):369-375.JG

Abstract

Background

The independent and combined effects of physical and cognitive domains of frailty in predicting the development of mild cognitive impairment (MCI) or dementia are not firmly established.

Methods

This study included cross-sectional and longitudinal analyses of physical frailty (Cardiovascular Health Study criteria), cognitive impairment (Mini-Mental State Examination [MMSE]), and neurocognitive disorder (DSM-5 criteria) among 1,575 community-living Chinese older adults from the Singapore Longitudinal Ageing Studies.

Results

At baseline, 2% were frail, 32% were prefrail, and 9% had cognitive impairment (MMSE score < 23). Frailty at baseline was significantly associated with prevalent cognitive impairment. Physical frailty categories were not significantly associated with incident NCD, but continuous physical frailty score and MMSE score showed significant individual and joint associations with incident mild NCD and dementia. Compared with those who were robust and cognitively normal, prefrail or frail old adults without cognitive impairment had no increased risk of incident NCD, but elevated odds of association with incident NCD were observed for robust with cognitive impairment (odds ratio [OR] = 4.04, p < .001), prefrail with cognitive impairment (OR = 2.22, p = .044), and especially for frail with cognitive impairment (OR = 6.37, p = .005). The prevalence of co-existing frailty and cognitive impairment (cognitive frailty) was 1% (95% confidence interval [CI]: 0.5-1.4), but was higher among participants aged 75 and older at 5.0% (95% CI: 1.8-8.1).

Conclusions

Physical frailty is associated with increased prevalence and incidence of cognitive impairment, and co-existing physical frailty and cognitive impairment confers additionally greater risk of incident NCD.

Authors+Show Affiliations

Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.Neuroscience and Behavioral Disorders Program, Duke-National University of Singapore Graduate Medical School, Singapore.Department of Psychological Medicine, National University Hospital, Singapore.Institute of Geriatrics and Active Ageing and. Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.Institute of Geriatrics and Active Ageing and. Department of Geriatric Medicine, Tan Tock Seng Hospital, Singapore.Department of Psychology, National University of Singapore, Singapore.Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore.Department of Geriatric Medicine, Alexandra Hospital, Singapore.Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27013397

Citation

Feng, Liang, et al. "Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies." The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, vol. 72, no. 3, 2017, pp. 369-375.
Feng L, Nyunt MS, Gao Q, et al. Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies. J Gerontol A Biol Sci Med Sci. 2017;72(3):369-375.
Feng, L., Nyunt, M. S., Gao, Q., Feng, L., Lee, T. S., Tsoi, T., Chong, M. S., Lim, W. S., Collinson, S., Yap, P., Yap, K. B., & Ng, T. P. (2017). Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies. The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 72(3), 369-375. https://doi.org/10.1093/gerona/glw050
Feng L, et al. Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies. J Gerontol A Biol Sci Med Sci. 2017 03 1;72(3):369-375. PubMed PMID: 27013397.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physical Frailty, Cognitive Impairment, and the Risk of Neurocognitive Disorder in the Singapore Longitudinal Ageing Studies. AU - Feng,Liang, AU - Nyunt,Ma Shwe Zin, AU - Gao,Qi, AU - Feng,Lei, AU - Lee,Tih Shih, AU - Tsoi,Tung, AU - Chong,Mei Sian, AU - Lim,Wee Shiong, AU - Collinson,Simon, AU - Yap,Philip, AU - Yap,Keng Bee, AU - Ng,Tze Pin, PY - 2015/03/22/received PY - 2016/03/01/accepted PY - 2016/3/26/pubmed PY - 2017/8/11/medline PY - 2016/3/26/entrez KW - Cognitive impairment KW - Frailty KW - Neurocognitive disorders SP - 369 EP - 375 JF - The journals of gerontology. Series A, Biological sciences and medical sciences JO - J Gerontol A Biol Sci Med Sci VL - 72 IS - 3 N2 - Background: The independent and combined effects of physical and cognitive domains of frailty in predicting the development of mild cognitive impairment (MCI) or dementia are not firmly established. Methods: This study included cross-sectional and longitudinal analyses of physical frailty (Cardiovascular Health Study criteria), cognitive impairment (Mini-Mental State Examination [MMSE]), and neurocognitive disorder (DSM-5 criteria) among 1,575 community-living Chinese older adults from the Singapore Longitudinal Ageing Studies. Results: At baseline, 2% were frail, 32% were prefrail, and 9% had cognitive impairment (MMSE score < 23). Frailty at baseline was significantly associated with prevalent cognitive impairment. Physical frailty categories were not significantly associated with incident NCD, but continuous physical frailty score and MMSE score showed significant individual and joint associations with incident mild NCD and dementia. Compared with those who were robust and cognitively normal, prefrail or frail old adults without cognitive impairment had no increased risk of incident NCD, but elevated odds of association with incident NCD were observed for robust with cognitive impairment (odds ratio [OR] = 4.04, p < .001), prefrail with cognitive impairment (OR = 2.22, p = .044), and especially for frail with cognitive impairment (OR = 6.37, p = .005). The prevalence of co-existing frailty and cognitive impairment (cognitive frailty) was 1% (95% confidence interval [CI]: 0.5-1.4), but was higher among participants aged 75 and older at 5.0% (95% CI: 1.8-8.1). Conclusions: Physical frailty is associated with increased prevalence and incidence of cognitive impairment, and co-existing physical frailty and cognitive impairment confers additionally greater risk of incident NCD. SN - 1758-535X UR - https://www.unboundmedicine.com/medline/citation/27013397/Physical_Frailty_Cognitive_Impairment_and_the_Risk_of_Neurocognitive_Disorder_in_the_Singapore_Longitudinal_Ageing_Studies_ L2 - https://academic.oup.com/biomedgerontology/article-lookup/doi/10.1093/gerona/glw050 DB - PRIME DP - Unbound Medicine ER -