School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, Italy.
Neurol Sci. 2023 Oct;44(10):3509-3514. doi: 10.1007/s10072-023-06885-8. Epub 2023 Jun 6.
Frailty is strongly associated with the clinical course of cognitive impairment and dementia, thus arguing for the need of its assessment in individuals affected by cognitive deficits. This study aimed to retrospectively evaluate frailty in patients aged 65 years and older referred to two Centers for Cognitive Decline and Dementia (CCDDs).
A total of 1256 patients consecutively referred for a first visit to two CCDDs in Lombardy (Italy) between January 2021 to July 2022 were included. All patients were evaluated by an expert physician in diagnosis and care of dementia according to a standardized clinical protocol. Frailty was assessed using a 24-items Frailty Index (FI) based on routinely collected health records, excluding cognitive decline or dementia, and categorized as mild, moderate, and severe.
Overall, 40% of patients were affected by mild frailty and 25% of the sample has moderate to severe frailty. The prevalence and severity of frailty increased with decreasing Mini Mental State Examination (MMSE) score and advancing age. Frailty was also detected in 60% of patients with mild cognitive impairment.
Frailty is common in patients referring to CCDDs for cognitive deficits. Its systematic assessment using a FI generated with readily available medical information could help develop appropriate models of assistance and guide personalization of care.
衰弱与认知障碍和痴呆的临床病程密切相关，因此需要对认知功能受损的个体进行衰弱评估。本研究旨在回顾性评估在意大利伦巴第地区两个认知减退和痴呆中心（CCDD）就诊的年龄在 65 岁及以上的患者的衰弱情况。
本研究共纳入了 2021 年 1 月至 2022 年 7 月期间连续到两个 CCDD 就诊的 1256 名患者。所有患者均由一名痴呆诊断和治疗专家根据标准化临床方案进行评估。采用基于常规健康记录的 24 项衰弱指数（FI）评估衰弱，排除认知减退或痴呆，并分为轻度、中度和重度。
总体而言，40%的患者存在轻度衰弱，25%的患者存在中重度衰弱。衰弱的患病率和严重程度随着简易精神状态检查（MMSE）评分的降低和年龄的增长而增加。在轻度认知障碍患者中，也发现了 60%的患者存在衰弱。
在因认知缺陷到 CCDD 就诊的患者中，衰弱很常见。使用易于获得的医疗信息生成 FI 进行系统评估，可以帮助制定适当的辅助模型，并指导个性化护理。
