衰弱老年人的认知功能和淀粉样蛋白标志物：COGFRAIL 队列研究。

Cognitive Function and Amyloid Marker in Frail Older Adults: The COGFRAIL Cohort Study.

机构信息

Sandrine Sourdet, MD - Hôpital de jour d'évaluation des fragilités, Service de Médecine Interne et Gérontologie Clinique, La Cité de la Santé, Hôpital La Grave, Place Lange, TSA 60033, 31059 Toulouse cedex 9, France, Phone: (33) 5 61 77 79 29, Fax: (33) 5 61 77 79 27, E-mail:

出版信息

J Frailty Aging. 2021;10(2):160-167. doi: 10.14283/jfa.2020.57.

DOI:10.14283/jfa.2020.57

PMID:33575706

Abstract

BACKGROUND

Frailty and cognitive impairment are common manifestations of the ageing process and are closely related. But the mechanisms linking aging, physical frailty, and cognitive disorders, are complex and remain unclear.

OBJECTIVES

We aim to explore the role of cerebral amyloid pathology, but also a range of nutritional, physical, biological or brain-aging marker in the development of cognitive frailty.

METHOD

COGFRAIL study is a monocentric prospective study of frail older patients with an objective cognitive impairment (Clinical Dementia Rating Scale global score at 0.5 or 1). Three-hundred-and-twenty-one patients are followed up every 6 months, for 2 years. Clinical assessment at baseline and during follow-up included frailty, physical, mood, sensory, nutritional, and cognitive assessment (with a set of neuropsychological tests). Cerebral amyloid pathology is measured by amyloid Positron Emission Tomography (PET) or amyloid-β-1-42 level in cerebrospinal fluid. Brain magnetic resonance imaging, measurement of body composition using Dual X Ray Absorptiometry and blood sampling are performed. The main outcome of the study is to assess the prevalence of positive cerebral amyloid status according to amyloid PET or amyloid-β-1-42 level CSF. Secondary outcomes included biological, nutritional, MRI imaging, cognitive, clinical, physical and body composition markers to better understand the mechanisms of cognitive frailty.

PERSPECTIVE

COGFRAIL study will give the opportunity to better understand the link between Gerosciences, frailty, cognitive impairment, and Alzheimer's disease, and to better characterize the physical and cognitive trajectories of frail older adults according to their amyloid status. Understanding the relationship between physical frailty and cognitive impairment is a prerequisite for the development of new interventions that could prevent and treat both conditions.

摘要

背景

衰弱和认知障碍是衰老过程中的常见表现，两者密切相关。但是，将衰老、身体衰弱和认知障碍联系起来的机制是复杂的，目前仍不清楚。

目的

我们旨在探索脑淀粉样蛋白病理的作用，以及一系列营养、身体、生物或大脑衰老标志物在认知衰弱发展中的作用。

方法

COGFRAIL 研究是一项针对衰弱的老年患者的单中心前瞻性研究，这些患者存在客观的认知障碍（临床痴呆评定量表总分为 0.5 或 1）。321 名患者每 6 个月随访一次，随访 2 年。基线和随访期间的临床评估包括衰弱、身体、情绪、感觉、营养和认知评估（包括一套神经心理学测试）。脑淀粉样蛋白病理通过正电子发射断层扫描（PET）或脑脊液中淀粉样蛋白-β-1-42 水平进行测量。进行脑磁共振成像、使用双能 X 线吸收法测量身体成分和血液取样。该研究的主要结局是根据淀粉样蛋白 PET 或脑脊液中淀粉样蛋白-β-1-42 水平评估阳性脑淀粉样蛋白状态的患病率。次要结局包括生物学、营养、MRI 成像、认知、临床、身体和身体成分标志物，以更好地理解认知衰弱的机制。