Ageing and Age-Associated Disorders Research Group, Department of Medicine, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysia.
Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Eur Geriatr Med. 2022 Dec;13(6):1309-1316. doi: 10.1007/s41999-022-00673-x. Epub 2022 Jul 9.
To determine the risk of adverse outcomes among prefrail and frail individuals with and without cognitive impairment as well as those with isolated cognitive impairment compared to robust individuals without cognitive impairment.
Data from the Malaysian elders longitudinal research (MELoR) study were utilised. Baseline data were obtained from home-based computer-assisted interviews and hospital-based health-checks from 2013 to 2015. Protocol of MELoR study has been described in previous study (Lim in PLoS One 12(3):e0173466, 2017). Follow-up interviews were conducted in 2019 during which data on the adverse outcomes of falls, sarcopenia, hospitalization, and memory worsening were obtained. Sarcopenia at follow-up was determined using the strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC-F) questionnaire.
Follow-up data was available for 776 participants, mean (SD) age 68.1 (7.1) years and 57.1% women. At baseline, 37.1% were robust, 12.8% had isolated cognitive impairment, 24.1% were prefrail, 1.0% were frail, 20.2% were prefrail with cognitive impairment, and 4.8% had CF. Differences in age, ethnicity, quality of life, psychological status, function and comorbidities were observed across groups. The association between CF with hospitalisation and falls compared to robust individuals was attenuated by ethnic differences. Pre-frail individuals were at increased risk of memory worsening compared robust individuals [aOR(95%CI) = 1.69 (1.09-2.60)]. Frail [7.70 (1.55-38.20)], prefrail with cognitive impairment [3.35 (1.76-6.39)] and CF [6.15 (2.35-16.11)] were significantly more likely to be sarcopenic at 5-year follow-up compared to the robust group.
Cognitive frailty was an independently predictor of sarcopenia at 5-year follow-up. The relationship between CF with falls and hospitalization, however, appeared to be accounted for by ethnic disparities. Future studies should seek to unravel the potential genetic and lifestyle variations between ethnic groups to identify potential interventions to reduce the adverse outcomes associated with CF.
确定与认知正常的健壮个体相比，衰弱前期和衰弱个体以及单纯认知障碍个体与认知正常但衰弱个体相比，发生不良结局的风险。
本研究使用了马来西亚老年人纵向研究（MELoR）的数据。2013 年至 2015 年期间，通过家庭计算机辅助访谈和医院健康检查获得基线数据。MELoR 研究的方案已在前一篇研究（Lim 等人，PLoS One 12(3):e0173466, 2017）中进行了描述。2019 年进行了随访访谈，在此期间获得了跌倒、肌肉减少症、住院和记忆恶化等不良结局的数据。随访时的肌肉减少症通过力量、行走辅助、从椅子上站起来、爬楼梯和跌倒（SARC-F）问卷来确定。
776 名参与者完成了随访，平均（标准差）年龄 68.1（7.1）岁，57.1%为女性。基线时，37.1%为健壮，12.8%为单纯认知障碍，24.1%为衰弱前期，1.0%为衰弱，20.2%为衰弱伴认知障碍，4.8%为认知正常但衰弱。各组之间在年龄、种族、生活质量、心理状态、功能和合并症方面存在差异。与健壮个体相比，CF 与住院和跌倒的关联在考虑到种族差异后减弱。与健壮个体相比，衰弱前期个体记忆恶化的风险增加[优势比（95%置信区间）=1.69（1.09-2.60）]。衰弱[7.70（1.55-38.20）]、衰弱伴认知障碍[3.35（1.76-6.39）]和 CF[6.15（2.35-16.11）]在 5 年随访时发生肌肉减少症的可能性明显高于健壮组。
认知衰弱是 5 年随访时肌肉减少症的独立预测因素。然而，CF 与跌倒和住院的关系似乎可以用种族差异来解释。未来的研究应该努力揭示不同种族之间潜在的遗传和生活方式差异，以确定潜在的干预措施来减少与 CF 相关的不良结局。
