Gerontology department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium.
Gerontology department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Frailty in Ageing (FRIA) Research department, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, B-1090, Brussels, Belgium; Department of Geriatrics, Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, B-1090, Brussels, Belgium.
Ageing Res Rev. 2018 May;43:10-16. doi: 10.1016/j.arr.2018.01.003. Epub 2018 Feb 8.
Ageing is associated both with frailty and cognitive decline. The quest for a unifying approach has led to a new concept: cognitive frailty. This systematic review explores the contribution of cognitive assessment in frailty operationalization. PubMed, Web of Knowledge and PsycINFO were searched until December 2016 using the keywords aged; frail elderly; aged, 80 and over; frailty; diagnosis; risk assessment and classification, yielding 2863 hits. Seventy-nine articles were included, describing 94 frailty instruments. Two instruments were not sufficiently specified and excluded. 46% of the identified frailty instruments included cognition. Of these, 85% were published after 2010, with a significant difference for publication date (X = 8.45, p < .05), indicating increasing awareness of the contribution of cognitive deficits to functional decline. This review identified 7 methods of cognitive assessment: dementia as co-morbidity; objective cognitive-screening instruments; self-reported; specific signs and symptoms; delirium/clouding of consciousness; non-specific cognitive terms and mixed assessments. Although cognitive assessment has been increasingly integrated in recently published frailty instruments, this has been heterogeneously operationalized. Once the domains most strongly linked to functional decline will have been identified and operationalized, this will be the groundwork for the identification of reversible components, and for the development of preventive interventional strategies.
衰老是衰弱和认知能力下降的共同原因。为了寻求一种统一的方法，出现了一个新概念：认知衰弱。本系统评价探讨了认知评估在衰弱操作中的作用。通过使用关键词“aged”“frail elderly”“aged, 80 and over”“frailty”“diagnosis”“risk assessment and classification”，从 PubMed、Web of Knowledge 和 PsycINFO 数据库中搜索了截至 2016 年 12 月的文献，共得到 2863 个结果。有 79 篇文章符合纳入标准，描述了 94 种衰弱工具。其中有 2 种工具未作详细说明，被排除在外。确定的衰弱工具中有 46%包含认知功能。其中，85%是在 2010 年后发表的，出版日期有显著差异（X=8.45，p<.05），表明人们越来越意识到认知缺陷对功能下降的影响。本研究共识别出 7 种认知评估方法：痴呆作为合并症；客观认知筛查工具；自我报告；特定体征和症状；谵妄/意识模糊；非特异性认知术语和混合评估。虽然认知评估已经越来越多地纳入到最近发表的衰弱工具中，但这方面的操作仍然存在异质性。一旦确定并操作与功能下降关系最密切的领域，就可以确定可逆转的因素，并制定预防干预策略。
