Co-occurrence of cognitive impairment and physical frailty, and incidence of dementia: Systematic review and meta-analysis

Giulia Grande; Miriam L Haaksma; Debora Rizzuto; René J F Melis; Alessandra Marengoni; Graziano Onder; Anna-Karin Welmer; Laura Fratiglioni; Davide L Vetrano

doi:10.1016/j.neubiorev.2019.09.001

Co-occurrence of cognitive impairment and physical frailty, and incidence of dementia: Systematic review and meta-analysis

Neurosci Biobehav Rev. 2019 Dec:107:96-103. doi: 10.1016/j.neubiorev.2019.09.001. Epub 2019 Sep 3.

Authors

Giulia Grande¹, Miriam L Haaksma², Debora Rizzuto³, René J F Melis², Alessandra Marengoni⁴, Graziano Onder⁵, Anna-Karin Welmer³, Laura Fratiglioni⁶, Davide L Vetrano⁷

Affiliations

¹ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden. Electronic address: giulia.grande@ki.se.
² Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands.
³ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
⁴ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
⁵ Centro di Medicina dell'Invecchiamento, Department of Geriatrics, Università Cattolica del Sacro Cuore di Roma and IRCCS Fondazione Policlinico "A. Gemelli", Rome, Italy.
⁶ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stockholm Gerontology Research Center, Stockholm, Sweden.
⁷ Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Centro di Medicina dell'Invecchiamento, Department of Geriatrics, Università Cattolica del Sacro Cuore di Roma and IRCCS Fondazione Policlinico "A. Gemelli", Rome, Italy.

PMID: 31491474
DOI: 10.1016/j.neubiorev.2019.09.001

Abstract

Introduction: Cognitive impairment and frailty are important health determinants, independently associated with increased dementia risk. In this meta-analysis we aimed to quantify the association of the co-occurrence of cognitive impairment no dementia (CIND) and physical frailty with incident dementia.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used when reporting this review. We performed a systematic search on PubMed, Web of Science, and Embase databases for relevant articles. Longitudinal studies enrolling individuals with both CIND and physical frailty and reporting dementia incidence were eligible. Pooled estimates were obtained through random effect models and Mantel-Haenszel weighting.

Results: Out of 3684 articles, five (14302 participants) were included in the meta-analysis. In comparison to participants free from frailty and CIND, the pooled hazard ratio for dementia was 3.83 (95% confidence interval [CI]: 2.64-5.56) for isolated CIND, 1.47 (95%CI: 0.89-2.40) for isolated physical frailty, and 5.36 (95%CI: 3.26-8.81) for their co-occurrence.

Discussion: The co-occurrence of cognitive impairment and physical frailty is a clinical marker of incident dementia.

Keywords: Cognitive impairment; Dementia; Physical frailty.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't
Systematic Review

MeSH terms

Cognitive Dysfunction / epidemiology*
Comorbidity
Dementia / epidemiology*
Frailty / epidemiology*
Humans
Incidence