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Cognitive Frailty as a Risk Factor for Incident Disability During Late Life: A 24-Month Follow-Up Longitudinal Study

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

Association between cognitive frailty as identified by a new operational definition and incident disability in the community setting remains unclear. This will be the catalyst for preventive interventions designed to treat adverse health problems among elderlies.

Design

A 24-month follow-up longitudinal study on a community-based cohort.

Setting

Community-setting.

Participants

Participants included a total of 9,936 older adults aged 65 years or older.

Measurements

Frailty was characterized as slow walking speed or/and muscle weakness represented by grip strength. Cognitive function was assessed according to several tests. Cognitive impairment was defined below the age-education reference threshold. Participants were categorized into the four groups: robust, cognitive impairment alone, frailty alone, and cognitive frailty (both frail and cognitive impairment). Incident disability data was extracted from the Japanese Long-Term Care system.

Results

The prevalence of cognitive frailty was 11.2%. The cumulative incidence rates of incident disability in each group were also estimated (robust, 9.6/1,000 person-years (95% CI 7.9 to 11.7); cognitive impairment, 21.3/1,000 person years (95% CI 16.3 to 27.7); frailty, 45.4/1,000 person years (95% CI 39.5 to 52.3); and cognitive frailty, 79.9/1,000 person years (95% CI 68.6 to 93.1)). Adjusted Cox proportional hazard model revealed that the cognitive frailty group had the highest hazard ratio (HR 3.86, 95%CI 2.95–5.05, P < 0.001).

Conclusions

A proper operational definition was developed to determine cognitive frailty among elderlies. Cognitive frailty is more associated with incident disability in community-setting than cognitive impairment or physical frailty alone.

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Acknowledgment

We would like to thank the Obu city office for help with participant recruitment.

Funding

Funding: This work received financial support via the Health Labour Sciences Research Grant (23–001) from the Japanese Ministry of Health, Labour, and Welfare, and the Research Funding for Longevity Sciences (22–16) from the National Center for Geriatrics and Gerontology (NCGG), Japan. Additional support was provided by a Grant-in-Aid for Scientific Research (B) to H.S. and a Grant-in-Aid for JSPS Fellows from the Japan Society for the Promotion of Science to H. M. The funding source played no role in the design or conduct of the study; collection, management, analysis, or interpretation of the data; or preparation, review, or approval of the manuscript..

Author information

Authors and Affiliations

  1. Section for Health Promotion, Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-cho, Obu City, Aichi Prefecture, 474-8511, Japan

    Kota Tsutsumimoto, T. Doi, S. Nakakubo, M. Kim, S. Kurita & H. Ishii

  2. Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan

    H. Shimada

Authors
  1. Kota Tsutsumimoto
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  2. T. Doi
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  3. S. Nakakubo
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  4. M. Kim
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  5. S. Kurita
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  6. H. Ishii
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  7. H. Shimada
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Contributions

Author contributions: Tsutsumimoto planned the study and wrote the first draft of the manuscript, and coordinated the review and editing process leading to the final manuscript. Doi participated in the design of the study and wrote the paper. Nakakubo, Kim, Kurita and Ishii corrected data and contributed to the editorial process and review of the manuscript. Shimada supervised the study and suggested many of the ideas that have been pursued in this research, and participated in the planning, editorial, and review processes that led to the final manuscript.

Corresponding author

Correspondence to Kota Tsutsumimoto.

Ethics declarations

Conflicts of interest: none.

Ethical standards: Informed consent was obtained from all participants beforehand. This study’s protocol was approved by the Ethics Committee of the National Center for Geriatrics and Gerontology.

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Tsutsumimoto, K., Doi, T., Nakakubo, S. et al. Cognitive Frailty as a Risk Factor for Incident Disability During Late Life: A 24-Month Follow-Up Longitudinal Study. J Nutr Health Aging 24, 494–499 (2020). https://doi.org/10.1007/s12603-020-1365-9

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  • DOI: https://doi.org/10.1007/s12603-020-1365-9

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