The journal of nutrition, health & aging

, Volume 22, Issue 4, pp 549–554 | Cite as

Cognitive Dysfunction in Urban-Community Dwelling Prefrail Older Subjects

  • Hiroyuki Umegaki
  • T. Makino
  • H. Shimada
  • T. Hayashi
  • X. Wu Cheng
  • M. Kuzuya
Article

Abstract

Objectives

A number of studies have reported that frailty is cross-sectionally associated with cognitive decline and is also a risk for future cognitive decline or dementia; however, there have been only a few studies that focus on the association between prefrailty and cognitive dysfunction. In the current study, we investigated the association between prefrailty and cognition

Design

A cross-sectional study of the data obtained at registration in a randomized control trial.

Setting

Toyota, Japan.

Participants

Community-dwelling older subjects (male 54.6%) who had cognitive complaints.

Measurements

A battery of neuropsychological and physical assessments were performed. Prefrailty was defined as exhibiting one or two of the five Fried criteria (weight loss, exhaustion, weakness, slow gait speed and low physical activity). We performed a multiple regression analysis to investigate the associations of cognitive performance with prefrailty, adjusting for the factors that were significantly different between the robust and prefrailty groups. To assess the cognitive attributes that were significantly associated with prefrailty, logistic analysis was performed to see if one specific criterion of the five frailty criteria was associated with cognitive performance.

Results

The study subjects included 183 prefrail and 264 robust individuals. The prefrail subjects with cognitive complaints were older, less educated, more depressive, and more likely to have diabetes mellitus than the robust subjects. The prefrail subjects had lower performance in a wide-range of cognitive domains, and after adjustments for age, education, depressive mood, and diabetes mellitus, prefrailty was associated with a decline in delayed memory and processing speed. Among the components of the Fried criteria, slow gait speed and loss of activity were significantly associated with slow processing speed as assessed by the digit symbol substitution test.

Conclusion

The current results demonstrated that prefrailty was associated with worse memory and processing speed performance, but not with other cognitive domains.

Key words

Neuropsychological assessments memory processing speed digit symbol substitution diabetes mellitus depression 

References

  1. 1.
    Ministry of Health, Labour, and Welfare. Number of elderly persons with dementia. 2015. Available at: http://www.mhlw.go.jp/stf/houdou/2r9852000002iau1-att/2r9852000002iavi.pdf. Accessed, July 8 in 2017 (in Japanese).Google Scholar
  2. 2.
    Vermeiren S, Vella-Azzopardi R, Beckwée D et al. Frailty and the Prediction of Negative Health Outcomes: A Meta-Analysis. J Am Med Dir Assoc, 2016; 17(12): 1163.e1–1163CrossRefGoogle Scholar
  3. 3.
    Bauer JM, Sieber CC. Sarcopenia and frailty: a clinician’s controversial point of view. Exp Gerontol, 2008; 43: 674–678.CrossRefPubMedGoogle Scholar
  4. 4.
    Fried LP, Tangen CM, Walston J et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci, 2001; 56A: M146–M156.CrossRefGoogle Scholar
  5. 5.
    Blaum CS, Xue QL, Michelon E et al. The association between obesity and the frailty syndrome in older women: the Women’s Health and Aging Studies. J Am Geriatr Soc, 2005; 53: 927–934.CrossRefPubMedGoogle Scholar
  6. 6.
    Danon-Hersch N, Rodondi N, Spagnoli J, Santos-Eggimann B. Prefrailty and chronic morbidity in the youngest old: an insight from the Lausanne cohort Lc65+. J Am Geriatr Soc, 2012; 60: 1687–1694.CrossRefPubMedGoogle Scholar
  7. 7.
    Acosta-Benito MA, Sevilla-Machuca I. Using prefrailty to detect early disability. J Family Community Med, 2016; 23: 140–144.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Robertson DA, Savva GM, Kenny RA. Frailty and cognitive impairment—a review of the evidence and causal mechanisms. Ageing Res Rev, 2013; 12: 840–851.CrossRefPubMedGoogle Scholar
  9. 9.
    Nishiguchi S, Yamada M, Fukutani N et al. Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults. J Am Med Dir Assoc, 2015; 16: 120–124.CrossRefPubMedGoogle Scholar
  10. 10.
    Kulmala J, Nykänen I, Mänty M, Hartikainen S. Association between frailty and dementia: a population-based study. Gerontology, 2014; 60: 16–21CrossRefPubMedGoogle Scholar
  11. 11.
    Robertson DA, Savva GM, Coen RF, Kenny RA. Cognitive function in the prefrailty and frailty syndrome. J Am Geriatr Soc, 2014; 62: 2118–2124.CrossRefPubMedGoogle Scholar
  12. 12.
    Sánchez-García S, Sánchez-Arenas R, García-Peña C et al. Frailty among community-dwelling elderly Mexican people: prevalence and association with sociodemographic characteristics, health state and the use of health services. Geriatr Gerontol Int, 2014; 14: 395–402.CrossRefPubMedGoogle Scholar
  13. 13.
    Umegaki H. Sarcopenia and frailty in older patients with diabetes mellitus. Geriatr Gerontol Int, 2016; 16: 293–299.CrossRefPubMedGoogle Scholar
  14. 14.
    Gill TM, Gahbauer EA, Allore HG, Han L. Transitions between frailty states among community-living older persons. Arch Intern Med, 2006; 166: 418–423.CrossRefPubMedGoogle Scholar
  15. 15.
    Espinoza SE, Jung I, Hazuda H. Frailty transitions in the San Antonio Longitudinal Study of Aging. J Am Geriatr Soc, 2012; 60: 652–660.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Arai H, Satake S. English translation of the Kihon Checklist. Geriatr Gerontol Int, 2015; 15: 518–519.CrossRefPubMedGoogle Scholar
  17. 17.
    Maki Y, Ura C, Yamaguchi T et al. Effects of intervention using a community-based walking program for prevention of mental decline: a randomized controlled trial. J Am Geriatr Soc, 2012; 60: 505–510.CrossRefPubMedGoogle Scholar
  18. 18.
    American Psychiatric Association Diagnostic and Statistical Manual, 4th ed, APA Press, Washington, DC 1994.Google Scholar
  19. 19.
    Aisen PS, Petersen RC, Donohue MC et al. Clinical core of the Alzheimer’s disease neuroimaging initiative: progress and plans. Alzheimers Dement, 2010; 6: 239–246.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Guo Q, Zhao Q, Chen M et al. A comparison study of mild cognitive impairment with 3 memory tests among Chinese individuals. Alzheimer Dis Assoc Disord, 2009; 23: 253–259.CrossRefPubMedGoogle Scholar
  21. 21.
    Folstein MF, Folstein SE, McHugh PR: «Mini-mental state». A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res, 1975; 12: 189–198.CrossRefPubMedGoogle Scholar
  22. 22.
    Wechsler D. Wechsler Memory Scale-Revised Manual. San Antonio, Texas: The Psychological Corporation. 1987.Google Scholar
  23. 23.
    Wechsler D. Wechsler Adult Intelligence Scale-Third Edition. London: The Psychological Corporation Limited. 1997.Google Scholar
  24. 24.
    Spreen O, Strauss E. A compendium of neuropsychological tests: Administration, norms and commentary (2nd ed.). New York: Oxford University Press. 1998.Google Scholar
  25. 25.
    Yesavage JA. The use of self-rating depression scales in the elderly, In: Clinical Memory Assessment of Older Adults, Poon LW (ed), Washington, DC, American Psychological Association, 1986; 213–217.CrossRefGoogle Scholar
  26. 26.
    Doi T, Shimada H, Makizako H et al. Cognitive function and gait speed under normal and dual-task walking among older adults with mild cognitive impairment. BMC Neurol, 2014; 14: 67–67.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    S Chen LK, Liu LK, Woo J et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc, 2014; 15: 95–101.CrossRefPubMedGoogle Scholar
  28. 28.
    Janssen I, Heymsfield SB, Ross R. Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc, 2002;50:889–96.CrossRefPubMedGoogle Scholar
  29. 29.
    Matsushita E, Okada K, Ito Y et al. Characteristics of physical prefrailty among Japanese healthy older adults. Geriatr Gerontol Int, 2016; doi: 10.1111/ggi.12935.Google Scholar
  30. 30.
    Veronese N, Stubbs B, Fontana L et al. Frailty is associated with an increased risk of incident type 2 diabetes in the elderly. J Am Med Dir Assoc, 2016; 17: 902–907. doi: 10.1016/j.jamda.2016.04.021.CrossRefPubMedGoogle Scholar
  31. 31.
    Rosano C, Perera S, Inzitari M et al. Digit Symbol Substitution test and future clinical and subclinical disorders of cognition, mobility and mood in older adults. Age Ageing, 2016; 45: 688–695.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Best JR, Liu-Ambrose T, Boudreau RM et al. Health, aging and body composition study. An evaluation of the longitudinal, bidirectional associations between gait speed and cognition in older women and men. J Gerontol A Biol Sci Med Sci, 2016; 71: 1616–1623.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Rosano C, Newman AB, Katz R et al. Association between lower digit symbol substitution test score and slower gait and greater risk of mortality and of developing incident disability in well-functioning older adults. J Am Geriatr Soc, 2008; 56: 1618–1625.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Weuve J, Kang JH, Manson JE et al. Physical activity, including walking, and cognitive function in older women. JAMA, 2004; 292: 1454–1461.CrossRefPubMedGoogle Scholar
  35. 35.
    van Gelder BM, Tijhuis MA, Kalmijn S et al. Physical activity in relation to cognitive decline in elderly men: the FINE Study. Neurology, 2004; 63: 2316–2321.CrossRefPubMedGoogle Scholar
  36. 36.
    Abbott RD, White LR, Ross GW et al. Walking and dementia in physically capable elderly men. JAMA, 2004; 292: 1447–1453.CrossRefPubMedGoogle Scholar
  37. 37.
    Taaffe DR, Irie F, Masaki KH et al. Physical activity, physical function, and incident dementia in elderly men: the Honolulu-Asia Aging Study. J Gerontol A Biol Sci Med Sci, 2008; 63: 529–535.CrossRefPubMedGoogle Scholar
  38. 38.
    Yaffe K, Barnes D, Nevitt M et al. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med, 2001; 161: 1703–1708.CrossRefPubMedGoogle Scholar
  39. 39.
    Kuiper JS, Zuidersma M, Zuidema SU et al. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies. Int J Epidemiol, 2016; 45: 1169–1206.PubMedGoogle Scholar
  40. 40.
    Cohen JA, Verghese J, Zwerling JL. Cognition and gait in older people. Maturitas, 2016; 93: 73–77.CrossRefPubMedGoogle Scholar
  41. 41.
    Verghese J, Wang C, Lipton RB, Holtzer R. Motoric cognitive risk syndrome and the risk of dementia. J Gerontol A Biol Sci Med Sci, 2013; 68: 412–418.CrossRefPubMedGoogle Scholar
  42. 42.
    Kelaiditi E, Cesari M, Canevelli M et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging, 2013; 17: 726–34.CrossRefPubMedGoogle Scholar
  43. 43.
    Delrieu J, Andrieu S, Pahor M et al. Neuropsychological Profile of «Cognitive Frailty» Subjects in MAPT Study. J Prev Alzheimers Dis, 2016;3:151–159.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Rosano C, Studenski SA, Aizenstein HJ et al. Slower gait, slower information processing and smaller prefrontal area in older adults. Age Ageing, 2012; 41: 58–64.CrossRefPubMedGoogle Scholar
  45. 45.
    Janssen HC, Emmelot-Vonk MH, Verhaar HJ, van der Schouw YT. Vitamin D and muscle function: is there a threshold in the relation? J Am Med Dir Assoc, 2013;14:627. e13-8.CrossRefPubMedGoogle Scholar
  46. 46.
    Bruyère O, Cavalier E, Buckinx F, Reginster JY. Relevance of vitamin D in the pathogenesis and therapy of frailty. Curr Opin Clin Nutr Metab Care, 2017; 20: 26–29.CrossRefPubMedGoogle Scholar
  47. 47.
    Zhou J, Huang P, Liu P et al. Association of vitamin D deficiency and frailty: A systematic review and meta-analysis. Maturitas, 2016; 94: 70–76.CrossRefPubMedGoogle Scholar
  48. 48.
    Shardell M, D’Adamo C, Alley DE et al. Serum 25-hydroxyvitamin D, transitions between frailty states, and mortality in older adults: the Invecchiare in Chianti Study. J Am Geriatr Soc, 2012; 60: 256–64.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Ensrud KE, Ewing SK, Fredman L et al. Circulating 25-hydroxyvitamin D levels and frailty status in older women. J Clin Endocrinol Metab, 2010; 95: 5266–73.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Chan DD, Tsou HH, Chang CB et al. Integrated care for geriatric frailty and sarcopenia: a randomized control trial. J Cachexia Sarcopenia Muscle, 2016; doi: 10.1002/jcsm.12132.Google Scholar
  51. 51.
    Luger E, Dorner TE, Haider S et al. Effects of a home-based and volunteeradministered physical training, nutritional, and social support program on malnutrition and frailty in older persons: A randomized controlled trial. J Am Med Dir Assoc, 2016;17:671. e9-671.e16.CrossRefPubMedGoogle Scholar
  52. 52.
    Qualls Cl, Waters DL, Vellas B et al. Reversible States of Physical and/or Cognitive Dysfunction: A 9-Year Longitudinal Study. J Nutr Health Aging. 2017; 21: 271–275.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Hiroyuki Umegaki
    • 1
  • T. Makino
    • 2
  • H. Shimada
    • 3
  • T. Hayashi
    • 2
  • X. Wu Cheng
    • 2
  • M. Kuzuya
    • 1
    • 2
  1. 1.Department of Community Healthcare & GeriatricsNagoya University Graduate School of MedicineNagoya, AichiJapan
  2. 2.Institute of Innovation for Future SocietyNagoya UniversityAichiJapan
  3. 3.Department of Preventive Gerontology, Center for Gerontology and Social ScienceNational Center for Geriatrics and GerontologyObuJapan

Personalised recommendations