Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy.
Public Health Section, Local Health Authority n. 2 Marca Trevigiana, Treviso, Italy.
J Alzheimers Dis. 2018;62(4):1623-1634. doi: 10.3233/JAD-170938.
Frailty is a condition which is characterized by a reduction in the homeostatic reserves of the individual and which entails an increased vulnerability to stressful endogenous and exogenous agents. The Frailty Index (FI), proposed by Rockwood, was designed following an accumulation of deficits model: the greater the number of deficits in a given individual, the greater the degree of frailty.
The aim of this study was to verify the existence of associations between FI and cerebral atrophy.
The TREDEM Register (Treviso Dementia) provided retrospective observational data from 1,584 patients. The FI was calculated based on 50 variables comprising diseases, disability, behavioral disturbances, and blood chemistry parameters. The severity of atrophy in the cortical and subcortical regions, such as the amplitude of the lateral ventricles, were detected by computerized axial tomography (CAT). Multiple logistic regression models using the stepwise backward method were used to analyze possible associations between FI and atrophy.
For each increment of one hundredth of the FI, the probability of cortical atrophy increases by 2%. The female gender is a protective factor for cortical and subcortical atrophy. At each increase of one percent of the FI, the probability of a severe degree of cortical atrophy increases by 3%. The FI was significantly associated with frontal and temporal cortical atrophy. The relationship between overall subcortical atrophy and the FI was not significant, whereas it was the one with the severe degree of subcortical atrophy. The FI is significantly associated with the atrophy of the peri-insular subcortical region. Similar associations were found considering only demented patients.
The FI is associated with the presence, degree, and some localization of cerebral atrophy in a population of cognitive-decline patients.
衰弱是一种个体稳态储备减少的状态，会导致其对内源性和外源性应激源的脆弱性增加。Rockwood 提出的衰弱指数（FI）是基于累积缺陷模型设计的：给定个体的缺陷数量越多，衰弱程度越大。
本研究旨在验证 FI 与脑萎缩之间是否存在关联。
特雷维索痴呆症 TREDEM 登记处（Treviso Dementia）提供了 1584 名患者的回顾性观察数据。FI 根据 50 个变量计算，包括疾病、残疾、行为障碍和血液化学参数。通过计算机轴向断层扫描（CAT）检测皮质和皮质下区域（如侧脑室幅度）的萎缩程度。使用逐步后退法的多变量逻辑回归模型分析 FI 与萎缩之间的可能关联。
FI 每增加百分之一，皮质萎缩的概率增加 2%。女性是皮质和皮质下萎缩的保护因素。FI 每增加 1%，皮质严重萎缩的概率增加 3%。FI 与额颞叶皮质萎缩显著相关。FI 与全脑皮质下萎缩之间的关系不显著，但与皮质下严重程度的萎缩显著相关。FI 与岛周皮质下区域的萎缩显著相关。仅考虑痴呆患者也发现了类似的关联。
FI 与认知衰退患者大脑萎缩的存在、程度和某些部位有关。
