衰弱与痴呆的关联：一项基于人群的研究。

Association between frailty and dementia: a population-based study.

机构信息

Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland.

出版信息

Gerontology. 2014;60(1):16-21. doi: 10.1159/000353859. Epub 2013 Aug 17.

DOI:10.1159/000353859

PMID:23970189

Abstract

BACKGROUND

Frailty is commonly considered as a syndrome with several symptoms, including weight loss, exhaustion, weakness, slow walking speed and physical inactivity. It has been suggested that cognitive impairment should be included in the frailty index, however the association between frailty and cognition has not yet been fully established.

OBJECTIVE

To investigate cross-sectionally whether frailty is associated with cognitive impairment or clinically diagnosed dementia in older people.

METHODS

The study included a total of 654 persons aged 76-100 years (mean 82 ± 4.6). Frailty status of the participants was assessed using the Cardiovascular Health Study criteria. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Clinically diagnosed dementia was assessed by specialists using diagnostic criteria. The associations between frailty and cognition were investigated using logistic regression.

RESULTS

A total of 93 (14%) participants were classified as frail. Cognitive impairment (MMSE score <25) was observed among 171 (26%) persons and 134 (21%) persons had clinically diagnosed dementia. 97 (15%) persons had Alzheimer's disease, 19 (3%) had vascular dementia, 12 (2%) had dementia with Lewy bodies and 8 persons (1%) had some other type of dementia. Multivariate logistic regression models showed that frail persons were almost 8 times more likely to have cognitive impairment (OR 7.8, 95% CI 4.0-15.0), 8 times more likely to have some kind of dementia (OR 8.0, 95% CI 4.0-15.9), almost 6 times more likely to have vascular dementia (OR 5.6, 95% CI 1.2-25.8) and over 4 times more likely to have Alzheimer's disease (OR 4.5, 95% CI 2.1-9.6) than persons who were robust.

CONCLUSION

Frailty is strongly associated with cognitive impairment and clinically diagnosed dementia among persons aged 76 and older. It is possible that cognitive impairment is a clinical feature of frailty and therefore should be included in the frailty definition.

摘要

背景

衰弱通常被认为是一种具有多种症状的综合征，包括体重减轻、乏力、虚弱、行走缓慢和身体不活动。有人建议认知障碍应包括在衰弱指数中，但衰弱与认知之间的关联尚未完全确定。

目的

调查老年人中衰弱与认知障碍或临床诊断痴呆之间的横断面关系。

方法

本研究共纳入 654 名 76-100 岁（平均 82±4.6 岁）的参与者。使用心血管健康研究标准评估参与者的衰弱状态。使用简易精神状态检查（MMSE）评估认知功能。由专家根据诊断标准评估临床诊断的痴呆。使用逻辑回归分析衰弱与认知之间的关系。

结果

共有 93 名（14%）参与者被归类为衰弱。171 名（26%）患者存在认知障碍（MMSE 评分<25），134 名（21%）患者患有临床诊断的痴呆。97 名（15%）患者患有阿尔茨海默病，19 名（3%）患者患有血管性痴呆，12 名（2%）患者患有路易体痴呆，8 名（1%）患者患有其他类型的痴呆。多变量逻辑回归模型显示，衰弱患者发生认知障碍的可能性高出近 8 倍（OR 7.8，95%CI 4.0-15.0），发生某种类型痴呆的可能性高出近 8 倍（OR 8.0，95%CI 4.0-15.9），发生血管性痴呆的可能性高出近 6 倍（OR 5.6，95%CI 1.2-25.8），发生阿尔茨海默病的可能性高出 4 倍以上（OR 4.5，95%CI 2.1-9.6）。