Reversible Cognitive Frailty,Dementia, and All-Cause Mortality. The Italian Longitudinal Study on Aging |
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| Authors: | Vincenzo Solfrizzi Emanuele Scafato Davide Seripa Madia Lozupone Bruno P Imbimbo Angela D&#x;Amato Rosanna Tortelli Andrea Schilardi Lucia Galluzzo Claudia Gandin Marzia Baldereschi Antonio Di Carlo Domenico Inzitari Antonio Daniele Carlo Sabbà Giancarlo Logroscino Francesco Panza |
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| Institution: | 1. Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy;2. Population Health and Health Determinants Unit, National Center for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy;3. Gerontology-Geriatrics Research Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy;4. Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy;5. Research and Development Department, Chiesi Farmaceutici, Parma, Italy;6. Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy;7. Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy;8. Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy;9. Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy |
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| Abstract: | ObjectivesCognitive 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.DesignLongitudinal population-based study with 3.5- and 7-year of median follow-up.SettingEight Italian municipalities included in the Italian Longitudinal Study on Aging.ParticipantsIn 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.MeasurementsIncidence of dementia, its subtypes, and all-cause mortality.ResultsOver 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.ConclusionsA 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. |
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| Keywords: | Frailty cognitive aging vascular dementia Alzheimer disease dementia mortality |
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