title: Reversible Cognitive Frailty, Dementia, and All-Cause Mortality. The Italian Longitudinal Study on Aging.
abstract: Cognitive frailty, a condition describing the simultaneous presence of physical frailty and mild cognitive impairment, has been recently defined by an international consensus group. We estimated the predictive role of a "reversible" cognitive frailty model on incident dementia, its subtypes, and all-cause mortality in nondemented older individuals. We verified if vascular risk factors or depressive symptoms could modify this predictive role.
  
  
  
  Longitudinal population-based study with 3.5- and 7-year of median follow-up.
  
  
  
  Eight Italian municipalities included in the Italian Longitudinal Study on Aging.
  
  
  
  In 2150 older individuals from the Italian Longitudinal Study on Aging, we operationalized reversible cognitive frailty with the presence of physical frailty and pre-mild cognitive impairment subjective cognitive decline, diagnosed with a self-report measure based on item 14 of the Geriatric Depression Scale.
  
  
  
  Incidence of dementia, its subtypes, and all-cause mortality.
  
  
  
  Over a 3.5-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia [hazard ratio (HR) 2.30, 95% confidence interval (CI) 1.02-5.18], particularly vascular dementia (VaD), and all-cause mortality (HR 1.74, 95% CI 1.07-2.83). Over a 7-year follow-up, participants with reversible cognitive frailty showed an increased risk of overall dementia (HR 2.12, 95% CI 1.12-4.03), particularly VaD, and all-cause mortality (HR 1.39, 95% CI 1.03-2.00). Vascular risk factors and depressive symptoms did not have any effect modifier on the relationship between reversible cognitive frailty and incident dementia and all-cause mortality.
  
  
  
  A model of reversible cognitive frailty was a short- and long-term predictor of all-cause mortality and overall dementia, particularly VaD. The absence of vascular risk factors and depressive symptoms did not modify the predictive role of reversible cognitive frailty on these outcomes.
authors.affiliation: Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Solfrizzi
authors.affiliation: Population Health and Health Determinants Unit, National Center for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scafato
authors.affiliation: Gerontology-Geriatrics Research Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Seripa
authors.affiliation: Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Madia
authors.initials: M
authors.lastname: Lozupone
authors.affiliation: Research and Development Department, Chiesi Farmaceutici, Parma, Italy.
authors.forename: Bruno P
authors.initials: BP
authors.lastname: Imbimbo
authors.affiliation: Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: D'Amato
authors.affiliation: Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Tortelli
authors.affiliation: Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Schilardi
authors.affiliation: Population Health and Health Determinants Unit, National Center for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Galluzzo
authors.affiliation: Population Health and Health Determinants Unit, National Center for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Roma, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Gandin
authors.affiliation: Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Baldereschi
authors.affiliation: Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.affiliation: Institute of Neuroscience, Italian National Research Council (CNR), Firenze, Italy; Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.affiliation: Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Daniele
authors.affiliation: Department of Geriatric Medicine, Memory Unit and Rare Disease Center, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Sabbà
authors.affiliation: Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Logroscino
authors.affiliation: Gerontology-Geriatrics Research Laboratory, Istituto di Ricovero e Cura a Carattere Scientifico Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy; Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy; Department of Clinical Research in Neurology, University of Bari Aldo Moro, Pia Fondazione Cardinale G. Panico, Tricase, Lecce, Italy. Electronic address: geriat.dot@geriatria.uniba.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Panza
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002423:Cause of Death; D060825:Cognitive Dysfunction; D003704:Dementia; D005260:Female; D000073496:Frailty / Q000523:psychology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000639:trends*; D016016:Proportional Hazards Models
keywords: Alzheimer disease; Frailty; cognitive aging; dementia; mortality; vascular dementia