We aimed to examine the longitudinal association between frailty and cognitive impairment in the older Chinese population. This prospective cohort study used data from the Chinese Longitudinal Healthy Longevity Study 2011 wave. We calculated the follow-up duration as 3 years from the baseline year. Frailty was measured using the frailty index, and cognitive function was calculated by Mini-Mental State Examination Scale. Participants who were non-frailty and those with normal cognitive function were included in 2011 and followed up in 2014, respectively. Frailty was an independent risk factor for early-onset cognitive impairment. Age, hearing impairment, and a decreased ability to perform daily activities were the main risk factors for cognitive impairment, while affluent economic status was a protective factor. Cognitive impairment was not found to be an independent risk factor for frailty. We concluded that the frailty index is a significant predictor of cognitive impairment among community-dwelling older adults.
BorgesM. K.CanevelliM.CesariM.AprahamianI. (2019). Frailty as a predictor of cognitive disorders: A systematic review and meta-analysis. Frontiers in Medicine, 6, 26. https://doi.org/10.3389/fmed.2019.00026
2.
BrigolaA. G.OttavianiA. C.CarvalhoD. H. T.OliveiraN. A.SouzaÉ. N.PavariniS. C. I. (2020). Association between cognitive impairment and criteria for frailty syndrome among older adults. Arquivos de Neuro-Psiquiatria, 78(1), 2–8. https://doi.org/10.1590/0004-282X20190138
3.
ChanK. Y.WangW.WuJ. J.LiuL.TheodoratouE.CarJ.MiddletonL.RussT. C.DearyI. J.CampbellH.wangW.RudanI.. Global Health Epidemiology Reference Group (GHERG) (2013). Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990–2010: A systematic review and analysis. Lancet, 381(9882), 2016–2023. https://doi.org/10.1016/S0140-6736(13)60221-4
4.
ChenQ.TangB.ZhaiY.ChenY.JinZ.HanH.GaoY.WuC.ChenT.HeJ. (2020). Dynamic statistical model for predicting the risk of death among older Chinese people, using longitudinal repeated measures of the frailty index: A prospective cohort study. Age and Ageing, 49(6), 966–973. https://doi.org/10.1093/ageing/afaa056
5.
ChongM. S.TayL.ChanM.LimW. S.YeR.TanE. K.DingY. Y. (2015). Prospective longitudinal study of frailty transitions in a community-dwelling cohort of older adults with cognitive impairment. BMC Geriatrics, 15(1), 175. https://doi.org/10.1186/s12877-015-0174-1
6.
ChristensenK.ThinggaardM.OksuzyanA.SteenstrupT.Andersen-RanbergK.JeuneB.McGueM.VaupelJ. W. (2013). Physical and cognitive functioning of people older than 90 years: A comparison of two Danish cohorts born 10 years apart. Lancet, 382(9903), 1507–1513. https://doi.org/10.1016/S0140-6736(13)60777-1
7.
CuiG.H.YaoY.H.XuR.F. (2011). QCognitive impairment using education-based cutoff points for CMMSE scores in elderly Chinese people of agricultural and rural Shanghai China. Acta Neurologica Scandinavica (124, pp. 361–367). https://doi:10.1111/j.1600-0404.2010.01484.x
8.
DaviesK.MaharaniA.ChandolaT.ToddC.PendletonN. (2021). The longitudinal relationship between loneliness, social isolation, and frailty in older adults in England: A prospective analysis. Lancet Healthy Longevity, 2(2), e70–e77. https://doi.org/10.1016/S2666-7568(20)30038-6
EsfandiariE.MillerW.C.AsheM.C. (2021). The effect of telehealth interventions on function and quality of life for older adults with pre-frailty or frailty: A systematic review and meta-analysis. Journal of Applied Gerontology, 40(11), 1649–1658. https://doi:.org./10.1177/0733464820983630
11.
FanJ.YuC.GuoY.BianZ.SunZ.YangL.ChenY.DuH.LiZ.LeiY.SunD.ClarkeR.ChenJ.ChenZ.LvJ.LiL.China Kadoorie Biobank Collaborative Group (2020). Frailty index and all-cause and cause-specific mortality in Chinese adults: A prospective cohort study. Lancet Public Health, 5(12), e650–e660. https://doi.org/10.1016/S2468-2667(20)30113-4
12.
FolsteinM. F.FolsteinS. E.McHughP. R. (1975). ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198. https://doi.org/10.1016/0022-3956(75)90026-6
13.
GogginsW. B.WooJ.ShamA.HoS. C. (2005). Frailty index as a measure of biological age in a Chinese population. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 60(8), 1046–1051. https://doi.org/10.1093/gerona/60.8.1046
14.
HalilM.Cemal KizilarslanogluM.Emin KuyumcuM.YesilY.Cruz JentoftA. J. (2015). Cognitive aspects of frailty: Mechanisms behind the link between frailty and cognitive impairment. Journal of Nutrition, Health and Aging, 19(3), 276–283. https://doi.org/10.1007/s12603-014-0535-z
15.
HoogendijkE. O.AfilaloJ.EnsrudK. E.KowalP.OnderG.FriedL. P. (2019). Frailty: Implications for clinical practice and public health. Lancet, 394(10206), 1365–1375. https://doi.org/10.1016/S0140-6736(19)31786-6
16.
Jean-PierreM.MatildeL.MikeM.MatthewP. (2021). WHO’s report for the decade of healthy ageing 2021–30 sets the stage for globally comparable data on healthy ageing. The Lancet Healthy Longevity, 2(3), E121–E122. https://doi.org/10.1016/S2666-7568(21)00002-7
17.
KojimaG.TaniguchiY.IliffeS.WaltersK. (2016). Frailty as a predictor of Alzheimer disease, vascular dementia, and all dementia among community-dwelling older people: A systematic review and meta-analysis. Journal of the American Medical Directors Association, 17(10), 881–888. https://doi.org/10.1016/j.jamda.2016.05.013
18.
LaidlawK.WangD.CoelhoC.PowerM. (2010). Attitudes to aging and expectations for filial piety across Chinese and British cultures: A pilot exploratory evaluation. Aging & Mental Health, 14(3), 283–292. https://doi:org/10.1080/13607860903483060
19.
LawtonM. P.BrodyE. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9(3), 179–186. https://doi.org/10.1093/geront/9.3_part_1.179
20.
MaL.ZhangL.SunF.LiY.TangZ. (2019). Cognitive function in prefrail and frail community-dwelling older adults in China. BMC Geriatrics, 19(1), 53. https://doi.org/10.1186/s12877-019-1056-8
21.
MitnitskiA. B.MogilnerA. J.RockwoodK. (2001). Accumulation of deficits as a proxy measure of aging. [Thescientificworldjournal Electronic Resource], 1, 323–336. https://doi.org/10.1100/tsw.2001.58
22.
NguyenH. T.BlackS. A.RayL. A.EspinoD. V.MarkidesK. S. (2003). Cognitive impairment and mortality in older Mexican Americans. Journal of the American Geriatrics Society, 51(2), 178–183. https://doi.org/10.1046/j.1532-5415.2003.51055.x
23.
Ofori-AsensoR.ChinK. L.MazidiM.ZomerE.IlomakiJ.ZulloA. R.GasevicD.AdemiZ.KorhonenM J.LoGuidiceD.BellJ. S.LiewD. (2019). Global incidence of frailty and prefrailty among community-dwelling older adults: A systematic review and meta-analysis. JAMA Network Open, 2(8), Article e198398. https://doi.org/10.1001/jamanetworkopen.2019.8398
24.
RobertsonD. A.SavvaG. M.KennyR. A. (2013). Frailty and cognitive impairment—a review of the evidence and causal mechanisms. Ageing Research Reviews, 12(4), 840–851. https://doi.org/10.1016/j.arr.2013.06.004
25.
RockwoodK.MitnitskiA. (2007). Frailty in relation to the accumulation of deficits. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 62(7), 722–727. https://doi.org/10.1093/gerona/62.7.722
SargentL.NallsM.AmellaE. J.SlattumP. W.MuellerM.BandinelliS.TianQ.Swift-ScanlanT.LagemanS. K.SingletonA. (2020). Shared mechanisms for cognitive impairment and physical frailty: A model for complex systems. Alzheimer’s and Dementia, 6(1), e12027. https://doi.org/10.1002/trc2.12027
28.
SargentL.NallsM.StarkweatherA.HobgoodS.ThompsonH.AmellaE. J.SingletonA. (2018). Shared biological pathways for frailty and cognitive impairment: A systematic review. Ageing Research Reviews, 47, 149–158. https://doi.org/10.1016/j.arr.2018.08.001
29.
SearleS. D.MitnitskiA.GahbauerE. A.GillT. M.RockwoodK. (2008). A standard procedure for creating a frailty index. BMC Geriatrics, 8(1), 24. https://doi.org/10.1186/1471-2318-8-24
30.
SongX.MitnitskiA.RockwoodK. (2010). Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. Journal of the American Geriatrics Society, 58(4), 681–687. https://doi.org/10.1111/j.1532-5415.2010.02764.x
31.
StenholmS.FerrucciL.VahteraJ.HoogendijkE. O.HuismanM.PenttiJ.LindbohmJ. V.BandinelliS.GuralinkJ. M.KivimäkiM. (2019). Natural course of frailty components in people who develop frailty syndrome: Evidence from two cohort studies. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences, 74(5), 667–674. https://doi.org/10.1093/gerona/gly132
32.
StillmanG. R.StillmanA. N.Beecher& M. S. (2021). Frailty is associated with early Hospital Readmission in older medical patients. Journal of Applied Gerontology, 40(1), 38–46. https://doi.org/10.1177/0733464819894926
33.
SuY.DongJ.SunJ.ZhangYMaSLiMZhangAChengBCaiSBaoQWangSZhuP (2021). Cognitive function assessed by Mini-mental state examination and risk of all-cause mortality: A community-based prospective cohort study. BMC Geriatrics, 21(1), 524. https://doi:10.1186/s12877-021-02471-9
34.
SuoC.SinghM. F.GatesN.WenW.SachdevP.BrodatyH.SaigalN.WilsonG. C.MeiklejohnJ.SinghN.BauneB. T.BakerM.ForoughiN.WangY.MavrosY.LampitA.LeungI.ValenzuelaM. J. (2016). Therapeutically relevant structural and functional mechanisms triggered by physical and cognitive exercise. Molecular Psychiatry11Erratum in: Molecular Psychiatry (2121, pp. 1642).
35.
VerbruggeL. M.BrownD. C.ZajacovaA. (2017). Disability rises gradually for a cohort of older Americans. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 72(1), 151–161. https://doi.org/10.1093/geronb/gbw002
36.
VermeirenS.Vella-AzzopardiR.BeckwéeD.HabbigA. K.SacfoglieriA.JansenB.BautmansI.Garontoplee Brussels Study Group VerteD.BeyerI.PetrovicM.De DonderL.KardolT.RossiG.ClarysP.ScafoglieriA.CattrysseE.de HertP. (2016). Frailty and the prediction of negative health outcomes: A meta-analysis. Journal of the American Medical Directors Association, 1(12), Articlee11163. https://doi.org/10.1016/j.jamda.2016.09.010
37.
WallaceL.M.K.TheouO.GodinJ.AndrewM.K.BennettD.A.RockwoodK. (2019). Investigation of frailty as a moderator of the relationship between neuropathology and dementia in Alzheimer's disease: A cross-sectional analysis of data from the Rush memory and aging Project. Lancet NeurologyLancet Neurology, 1818(2), 177–184. https://doi.org/10.1016/S1474-4422(18)30371-5
38.
WangJ.WangF.HanP.LiuY.MaW.ZhangH.YuX.XieF.NiuS.HuH.ZhuX.WangH.YUY.GuoQ. (2021). Gender-specific associations of speech-frequency hearing loss, high-frequency hearing loss, and cognitive impairment among older community dwellers in China. Aging Clinical and Experimental research, 34(4), 857–868. https://doi.org/10.1007/s40520-021-01990-0
39.
WienerJ. M.HanleyR. J.ClarkR.Van NostrandJ. F. (1990). Measuring the activities of daily living: Comparisons across national surveys. Journal of Gerontology, 45(6), S229–S237. https://doi.org/10.1093/geronj/45.6.s229
40.
WuC. Y.ChouY. C.HuangN.ChouY. J.HuH. Y.LiC. P. (2014). Cognitive impairment assessed at annual geriatric health examinations predicts mortality among the elderly. Preventive Medicine, 67, 28–34. https://doi.org/10.1016/j.ypmed.2014.06.027
41.
WuX.HouG.HanP.YuX.ChenX.SongP.ZhangY.ZhaoY.XieF.NiuS.HuH.SunC.ZhaoY.WangH.GuoQ. (2021). Association between physical performance and cognitive function in Chinese community-dwelling older adults: Serial mediation of malnutrition and depression. Clinical Interventions in Aging, 16, 1327–1335. https://doi.org/10.2147/CIA.S315892
42.
ZengY. (2012). Towards deeper research and better policy for healthy aging—using the unique data of Chinese longitudinal healthy longevity survey. China Economic Journal, 5(2–3), 131–149. https://doi.org/10.1080/17538963.2013.764677
43.
ZengY.FengQ.HeskethT.ChristensenK.VaupelJ. W. (2017). Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: A cohort study. Lancet, 389(10079), 1619–1629. https://doi.org/10.1016/S0140-6736(17)30548-2
ZengY.PostonD. L.VloskyD. A.GuD. (2008). Healthy longevity in China: Demographic, socioeconomic, and psychological dimensions. Springer.
46.
ZengY.WangZ. (2014). A policy analysis on challenges and opportunities of population/household aging in China. Journal of Population Aging, 7(4), 255–281. https://doi.org/10.1007/s12062-014-9102-y
47.
ZhangH.MaW.ChenY.WangF.WangJ.HanP.WangY.ZhangC.XieF.NiuS.HuH.WangH.GuoQ. (2021). Long sleep duration associated with cognitive impairment in Chinese community-dwelling older adults. Journal of Nervous and Mental Disease, 209(12), 925–932. https://doi.org/10.1097/NMD.0000000000001401
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