title: Frailty syndrome and all-cause mortality in demented patients: the Italian Longitudinal Study on Aging.
abstract: Cognition has already been considered as a component of frailty, and it has been demonstrated that it is associated with adverse health outcomes. We estimated the prevalence of frailty syndrome in an Italian older population and its predictive role on all-cause mortality and disability in nondemented subjects and in demented patients. We evaluated 2,581 individuals recruited from the Italian Longitudinal Study on Aging, a population-based sample of 5,632 subjects, aged 65-84 years old. Participants received identical baseline evaluation at the 1st survey (1992-1993) and were followed at 2nd (1995-1996) and 3rd survey (2000-2001). A phenotype of frailty according to partially modified measurement of Cardiovascular Health Study criteria was operationalized. The overall prevalence of frailty syndrome in this population-based study was 7.6% (95% confidence interval (CI) 6.55-8.57). Frail individuals noncomorbid or nondisable were 9.1% and 39.3%, respectively, confirming an overlap but not concordance in the co-occurrence among these conditions. Frailty was associated with a significantly increased risk of all-cause mortality over a 3-year follow-up (hazard ratio (HR) 1.98, 95% confidence interval (CI) 1.52-2.60) and over a 7-year follow-up (HR 1.74, 95% CI 1.44-2.16), but with significant increased risk of disability only over a 3-year follow-up (HR 1.32, 95% CI 1.06-1.86 over a 3-year follow-up and HR 1.16, 95% CI 0.88-1.56 over a 7-year follow-up). Frail demented patients were at higher risk of all-cause mortality over 3- (HR 3.33, 95% CI 1.28-8.29) and 7-year follow-up periods (HR 1.89, 95% CI 1.10-3.44), but not of disability. Frailty syndrome was a short-term predictor of disability in nondemented older subjects and short- and long-term predictor of all-cause mortality in nondemented and demented patients.
authors.affiliation: Memory Unit, Center for Aging Brain, Department of Geriatrics, University of Bari-Policlinico, Italy. v.solfrizzi@geriatria.uniba.it
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Solfrizzi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scafato
authors.forename: Vincenza
authors.initials: V
authors.lastname: Frisardi
authors.forename: Daniele
authors.initials: D
authors.lastname: Sancarlo
authors.forename: Davide
authors.initials: D
authors.lastname: Seripa
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.forename: Marzia
authors.initials: M
authors.lastname: Baldereschi
authors.forename: Gaetano
authors.initials: G
authors.lastname: Crepaldi
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.forename: Lucia
authors.initials: L
authors.lastname: Galluzzo
authors.forename: Claudia
authors.initials: C
authors.lastname: Gandin
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.forename: Stefania
authors.initials: S
authors.lastname: Maggi
authors.forename: Alberto
authors.initials: A
authors.lastname: Pilotto
authors.forename: Francesco
authors.initials: F
authors.lastname: Panza
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002423:Cause of Death; D003071:Cognition / Q000502:physiology*; D003704:Dementia / Q000401:mortality* / Q000503:physiopathology; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013577:Syndrome