Ruan Qingwei, D'Onofrio Grazia, Sancarlo Daniele, Greco Antonio, Lozupone Madia, Seripa Davide, Panza Francesco, Yu Zhuowei
Shanghai Key Laboratory of Clinical Geriatrics, Department of Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Institute of Geriatrics and Gerontology, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
Geriatric Unit and Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.
Aging Clin Exp Res. 2017 Dec;29(6):1075-1086. doi: 10.1007/s40520-017-0741-8. Epub 2017 Mar 4.
Physical frailty and cognitive frailty are two important targets of secondary intervention in aging research to narrow the gap between life and health span. The objective of the present narrative review was to examine clinical and epidemiological studies investigating the recently proposed construct of cognitive frailty and its subtypes, with a focus on operational definitions, clinical criteria, and emerging biomarkers potentially useful for the screening of this novel entity. Both physical frailty and frailty indexes with a multidimensional nature were associated with late-life cognitive impairment/decline, incident dementia, Alzheimer's disease (AD), mild cognitive impairment, vascular dementia, non-AD dementias, and AD pathology proposing cognitive frailty as a clinical entity with cognitive impairment related to physical causes with a potential reversibility. The new clinical and research AD criteria established by the National Institute on Aging-Alzheimer's Association and the American Psychiatric Association could improve the differential diagnosis of cognitive impairment within the cognitive frailty construct. The emerging biomarkers of sarcopenia, physical frailty, and cognitive impairment will provide the basis to establish more reliable clinical and research criteria for cognitive frailty, using different operational definitions for frailty and cognitive impairment and useful clinical, biological, and imaging markers for this novel clinical construct.
身体衰弱和认知衰弱是衰老研究中二级干预的两个重要目标，旨在缩小生命与健康寿命之间的差距。本叙述性综述的目的是审视调查最近提出的认知衰弱及其亚型结构的临床和流行病学研究，重点关注操作定义、临床标准以及可能有助于筛查这一新型实体的新兴生物标志物。具有多维性质的身体衰弱和衰弱指数均与晚年认知障碍/衰退、新发痴呆、阿尔茨海默病（AD）、轻度认知障碍、血管性痴呆、非AD痴呆以及AD病理相关，提示认知衰弱是一种与身体原因相关且具有潜在可逆性的认知障碍临床实体。美国国立衰老研究所 - 阿尔茨海默病协会和美国精神病学协会制定的新的临床和研究AD标准，可改善认知衰弱结构内认知障碍的鉴别诊断。肌肉减少症、身体衰弱和认知障碍的新兴生物标志物，将为建立更可靠的认知衰弱临床和研究标准提供依据，为此使用不同的衰弱和认知障碍操作定义以及适用于这一新型临床结构的有用临床、生物学和影像学标志物。
