UConn Center on Aging (BSD, GAK), University of Connecticut Health Center, Farmington, CT; Department of Psychiatry, School of Medicine (BSD), University of Connecticut Health Center, Farmington, CT.
Center for Studies in Public Health and Aging (NESPE) (MFLC, SVP, JOAF, ECC), Rene Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil.
Am J Geriatr Psychiatry. 2022 Jul;30(7):825-833. doi: 10.1016/j.jagp.2022.01.012. Epub 2022 Feb 3.
Cognitive impairment and physical frailty are common among older adults and associated with a higher likelihood of adverse health outcomes. These two conditions frequently coexist in the same individual as cognitive frailty, yet few studies have examined the impact of such comorbidity on clinical outcomes or underlying biological mechanisms.
A total of 1,340 older adults (age ≥60 years old) from the Bambui Cohort Study of Ageing, with a total follow-up of 10 years, were included in this study. Frailty was defined by the accumulation of deficit framework and cognitive impairment based on scores on the MMSE less than 22. In addition, serum IL-6 levels were measured by cytometric bead array assay.
Individuals classified with cognitive frailty had significantly higher serum IL-6 levels compared to the robust, cognitively unimpaired group. Those with cognitive frailty (aOR = 1.97 [1.18-3.27] and prefrailty and cognitive impairment (aOR = 1.83 [1.24-2.69]) had the highest mortality risk over 10 years of follow-up. Higher IL-6 levels were also independently associated with a higher mortality rate (aOR = 1.37 [1.23-1.54]).
Our study shows that cognitive Frailty indicates a vulnerability state and of increasing mortality risk. Our findings also suggested that proinflammatory abnormalities can be viewed as a central phenomenon underlying common age-related problems (e.g., cognitive impairment and Frailty) and outcomes (e.g., mortality).
认知障碍和身体虚弱在老年人中很常见，并且与不良健康结果的可能性增加有关。这两种情况在同一个人身上经常同时存在，称为认知衰弱，但很少有研究探讨这种合并症对临床结果或潜在生物学机制的影响。
本研究共纳入了 1340 名来自 Bambui 老龄化队列研究的老年人（年龄≥60 岁），总随访时间为 10 年。根据 MMSE 评分<22 分，采用累积缺陷框架和认知障碍来定义衰弱。此外，还通过细胞计数珠阵列测定法来测量血清 IL-6 水平。
与身体强健、认知未受损的组相比，被归类为认知衰弱的个体的血清 IL-6 水平显著更高。认知衰弱者（aOR=1.97[1.18-3.27]）和衰弱前期合并认知障碍者（aOR=1.83[1.24-2.69]）在 10 年的随访期间死亡风险最高。较高的 IL-6 水平也与更高的死亡率独立相关（aOR=1.37[1.23-1.54]）。
我们的研究表明，认知衰弱表明一种脆弱状态，并且与更高的死亡率风险相关。我们的发现还表明，促炎异常可以被视为与常见与年龄相关的问题（如认知障碍和衰弱）和结果（如死亡率）相关的核心现象。
