Abstract
Background Cognitive frailty, defined as the presence of physical frailty and cognitive impairment in the absence of dementia, is a common finding among older adults. The causative factors for cognitive frailty are not well understood. It is known that vascular factors such as arterial stiffness are associated with ageing and frailty. In the Frailty and arterial stiffness- role of oxidative stress and inflammation (FRAXI) study, the correlation between cognitive frailty (assessed by the mini-mental state examination (MMSE)), clinical frailty score (CFS) and arterial stiffness was explored. Methods The longitudinal FRAXI study included fifty community dwelling adults ≥70years (mean age ± standard deviation: 79 ± 5years, 46% male), with CFS ≤ 6 and no active malignancy, who were followed up for six months. Measures of arterial stiffness included pulse wave velocity (PWV, Complior®) and cardioankle vascular index, measured at baseline. Other study measurements: MMSE, timed up and go test), sarcopenia, geriatric depression scale, interleukin-6 and high sensitivity C-reactive protein biomarkers were measured at baseline and 6 months. Results All fifty participants were assessed for cognition using MMSE, with mean CFS at baseline of 3.5 (±SD 1.4) and at follow up, 4.0 (± SD 1.5). At baseline, MMSE strongly correlated with both functional and phenotypic frailty as assessed by Charlson’s Comorbidity Index (r=-0.3; p<0.05) and CFS (r=-0.5; p<0.001). Similarly, MMSE strongly correlated with measures of arterial stiffness; PWV-carotid femoral (r=-0.4; p=0.01) and PWV-carotid radial (r=-0.4; p<0.005). At follow up, MMSE remained strongly correlated with CFS (r=-0.3; p<0.01). Conclusion Cognitive frailty correlates strongly with measures of vascular ageing. Arterial stiffness can be used as a vascular measure to identify older adults at risk of cognitive impairment
Comments
Very informative research…
Very informative research. Just to ask if this MMSE (suggesting cognitive frailty) correlation with arterial thickening would have been confounded by other underlying vascular risk factors for dementia such as long standing hypertension, diabetes, etc. Arterial thickening itself could be a sequalae of these conditions.
Very interesting
Really interesting research. Given the clear link between arterial stiffness and cognitive impairment, what would you suggest to reduce the risk in these patients? Do you feel the arterial stiffness is related to the normal ageing process, or more related to cardiovascular disease or associated risk factors?
Better assessment than bp
Great study.i wonder if this perhaps is a better assessment of risk also in terms of cvd than bp. Could vascular stiffness be used in this way?
Other outcome measures
Great finding! I was wondering if you ran a correlation analysis between TUG and arterial stiffness...