Additive Role of a Potentially Reversible Cognitive Frailty Model and Inflammatory State on the Risk of Disability: The Italian Longitudinal Study on Aging.
OBJECTIVE
Cognitive frailty is a condition recently defined by operationalized criteria describing the simultaneous presence of physical frailty and mild cognitive impairment (MCI). Two subtypes for this clinical construct have been proposed: "potentially reversible" cognitive frailty (physical frailty plus MCI) and "reversible" cognitive frailty (physical frailty plus pre-MCI subjective cognitive decline). Here the prevalence of a potentially reversible cognitive frailty model was estimated. It was also evaluated if introducing a diagnosis of MCI in older subjects with physical frailty could have an additive role on the risk of dementia, disability, and all-cause mortality in comparison with frailty state or MCI condition alone, with analyses separately performed for inflammatory state.


METHODS
In 2,373 individuals from the population-based Italian Longitudinal Study on Aging with a 3.5-year-follow-up, we operationally categorized older individuals without dementia into four groups: non-frail/non-MCI, non-frail/MCI, frail/non-MCI, and frail/MCI.


RESULTS
The prevalence of potentially reversible cognitive frailty was 1%, increasing with age and more represented in women than in men, and all groups were associated with significant increased incident rate ratios of dementia, disability, and mortality. A significant difference in rates of disability has been found between the MCI and non-MCI groups (contrasts of adjusted predictions: 0.461; 95% confidence interval: 0.187-0.735) in frail individuals with high inflammatory states (fibrinogen >339 mg/dL).


CONCLUSION
In older individuals without dementia and with elevated inflammation, a potentially reversible cognitive frailty model could have a significant additional predictive effect on the risk of disability than the single conditions of frailty or MCI.
['Solfrizzi|Vincenzo|V|', 'Scafato|Emanuele|E|', 'Lozupone|Madia|M|', 'Seripa|Davide|D|', 'Giannini|Michele|M|', 'Sardone|Rodolfo|R|', 'Bonfiglio|Caterina|C|', 'Abbrescia|Daniela I|DI|', 'Galluzzo|Lucia|L|', 'Gandin|Claudia|C|', 'Baldereschi|Marzia|M|', 'Di Carlo|Antonio|A|', 'Inzitari|Domenico|D|', 'Daniele|Antonio|A|', 'Sabbà|Carlo|C|', 'Logroscino|Giancarlo|G|', 'Panza|Francesco|F|', '|||']
D000368:Aged D000369:Aged, 80 and over D000375:Aging D060825:Cognitive Dysfunction D015897:Comorbidity D006233:Disabled Persons D005260:Female D005500:Follow-Up Studies D016330:Frail Elderly D000073496:Frailty D006801:Humans D007249:Inflammation D007558:Italy D008137:Longitudinal Studies D008297:Male D015995:Prevalence D012306:Risk
Frailty inflammation Alzheimer disease cognitive aging disablement process lifestyle