Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people

Hiroyuki Shimada, Hyuma Makizako, Takehiko Doi, Daisuke Yoshida, Kota Tsutsumimoto, Yuya Anan, Kazuki Uemura, Tadashi Ito, Sangyoon Lee, Hyuntae Park, Takao Suzuki
Journal of the American Medical Directors Association 2013, 14 (7): 518-24

OBJECTIVE: Preventive strategies for frailty and mild cognitive impairment (MCI) are important for avoiding future functional decline and dementia in older adults. The purpose of this study was to use a population-based survey to ascertain the single and combined prevalence of frailty and MCI and to identify the relationships between frailty and MCI in older Japanese adults.

DESIGN: Cross-sectional study.

SETTING: General community.

PARTICIPANTS: A total of 5104 older adults (aged 65 years or older, mean age 71 years) who were enrolled in the Obu Study of Health Promotion for the Elderly (OSHPE).

MEASUREMENTS: Each participant underwent detailed physical and cognitive testing to assess frailty and MCI. We considered the frailty phenotype to be characterized by limitations in 3 or more of the following 5 domains: mobility, strength, endurance, physical activity, and nutrition. Screening for MCI included a standardized personal interview, the Mini-Mental State Examination, and the National Center for Geriatrics and Gerontology-Functional Assessment Tool (NCGG-FAT), which included 8 tasks used to assess logical memory (immediate and delayed recognition), word list memory (immediate and delayed recall), attention and executive function (tablet version of Trail Making Test-part A and B), processing speed (tablet version of digit symbol substitution test), and visuospatial skill (figure selection).

RESULTS: The overall prevalence of frailty, MCI, and frailty and MCI combined was 11.3%, 18.8%, and 2.7%, respectively. We found significant relationships between frailty and MCI (the odds ratio adjusted for age, sex, and education was 2.0 (95% confidence interval 1.5-2.5).

CONCLUSIONS: Using the OSHPE criteria, we found more participants with MCI than with frailty. The prevalence of frailty and MCI combined was 2.7% in our population. Future investigation is necessary to determine whether this population is at increased risk for disability or mortality.

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