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Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging

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Abstract

Cognition has already been considered as a component of frailty, and it has been demonstrated that it is associated with adverse health outcomes. We estimated the prevalence of frailty syndrome in an Italian older population and its predictive role on all-cause mortality and disability in nondemented subjects and in demented patients. We evaluated 2,581 individuals recruited from the Italian Longitudinal Study on Aging, a population-based sample of 5,632 subjects, aged 65–84 years old. Participants received identical baseline evaluation at the 1st survey (1992–1993) and were followed at 2nd (1995–1996) and 3rd survey (2000–2001). A phenotype of frailty according to partially modified measurement of Cardiovascular Health Study criteria was operationalized. The overall prevalence of frailty syndrome in this population-based study was 7.6% (95% confidence interval (CI) 6.55–8.57). Frail individuals noncomorbid or nondisable were 9.1% and 39.3%, respectively, confirming an overlap but not concordance in the co-occurrence among these conditions. Frailty was associated with a significantly increased risk of all-cause mortality over a 3-year follow-up (hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.52–2.60) and over a 7-year follow-up (HR 1.74, 95% CI 1.44–2.16), but with significant increased risk of disability only over a 3-year follow-up (HR 1.32, 95% CI 1.06–1.86 over a 3-year follow-up and HR 1.16, 95% CI 0.88–1.56 over a 7-year follow-up). Frail demented patients were at higher risk of all-cause mortality over 3- (HR 3.33, 95% CI 1.28–8.29) and 7-year follow-up periods (HR 1.89, 95% CI 1.10–3.44), but not of disability. Frailty syndrome was a short-term predictor of disability in nondemented older subjects and short- and long-term predictor of all-cause mortality in nondemented and demented patients.

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Acknowledgments

This work was supported by the Italian Longitudinal Study on Aging (Italian National Research Council—CNR-Targeted Project on Ageing—Grants 9400419PF40 and 95973PF40) and by the Ministero della Salute, IRCCS Research Program 2009–2011, Line 2: “Malattie complesse.” The researchers operate independently of the funders of the study.

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Authors and Affiliations

  1. Memory Unit, Center for Aging Brain, Department of Geriatrics, University of Bari—Policlinico, Piazza Giulio Cesare, 11-70124, Bari, Italy

    Vincenzo Solfrizzi & Vincenza Frisardi

  2. Population Health and Health Determinants Unit, National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy

    Emanuele Scafato, Lucia Galluzzo & Claudia Gandin

  3. Geriatric Unit and Gerontology-Geriatric Research Laboratory, IRCCS Casa Sollievo della Sofferenza, Viale Cappuccini 1, 71013, San Giovanni Rotondo, Foggia, Italy

    Daniele Sancarlo, Davide Seripa, Alberto Pilotto & Francesco Panza

  4. Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy

    Giancarlo Logroscino

  5. Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy

    Marzia Baldereschi & Antonio Di Carlo

  6. Aging Section, Italian National Research Council (CNR), Padua, Italy

    Gaetano Crepaldi & Stefania Maggi

  7. Department of Neurological and Psychiatric Sciences, University of Firenze, Firenze, Italy

    Domenico Inzitari

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  1. Vincenzo Solfrizzi
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  2. Emanuele Scafato
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  9. Antonio Di Carlo
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  10. Lucia Galluzzo
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  15. Francesco Panza
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for the Italian Longitudinal Study on Aging Working Group

Corresponding authors

Correspondence to Vincenzo Solfrizzi or Francesco Panza.

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The ILSA Working Group

E. Scafato, MD (Scientific Coordinator), G. Farchi, MSc, L. Galluzzo, MA, C. Gandin, MD, Istituto Superiore di Sanità, Rome; A. Capurso, MD, F. Panza, MD, PhD, V. Solfrizzi, MD, PhD, V. Lepore, MD, P. Livrea, MD, University of Bari; L. Motta, MD, G. Carnazzo, MD, M. Motta, MD, P. Bentivegna, MD, University of Catania; S. Bonaiuto, MD, G. Cruciani, MD, D. Postacchini, MD, Italian National Research Centre on Aging, Fermo; D. Inzitari, MD, L. Amaducci, MD, University of Firenze; A. Di Carlo, MD, M. Baldereschi, MD, Italian National Research Council, Firenze; C. Gandolfo, MD, M. Conti, MD, University of Genova; N. Canal, MD, M. Franceschi, MD, San Raffaele Institute, Milan; G. Scarlato, MD, L. Candelise, MD, E. Scapini, MD, University of Milano; F. Rengo, MD, P. Abete, MD, F. Cacciatore, MD, University of Napoli; G. Enzi, MD, L. Battistin, MD, G. Sergi, MD, G. Crepaldi, MD, University of Padova; S. Maggi, MD, N. Minicucci, MD, M. Noale, MD, Italian National Research Council, Aging Section, Padova; F. Grigoletto, ScD, E. Perissinotto, ScD, Institute of Hygiene, University of Padova; P. Carbonin, MD, Università Cattolica del Sacro Cuore, Rome.

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Solfrizzi, V., Scafato, E., Frisardi, V. et al. Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging. AGE 34, 507–517 (2012). https://doi.org/10.1007/s11357-011-9247-z

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