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Link to original content: http://www.ncbi.nlm.nih.gov/pubmed/30400831
Prevalence of frailty, cognitive impairment, and sarcopenia in outpatients with cardiometabolic disease in a frailty clinic - PubMed Skip to main page content
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Observational Study
. 2018 Nov 6;18(1):264.
doi: 10.1186/s12877-018-0955-4.

Prevalence of frailty, cognitive impairment, and sarcopenia in outpatients with cardiometabolic disease in a frailty clinic

Yoshiaki Tamura  1 , Joji Ishikawa  2 , Yoshinori Fujiwara  3 , Masashi Tanaka  4 , Nobuo Kanazawa  5 , Yuko Chiba  6 , Ai Iizuka  3 , Sho Kaito  3 , Jun Tanaka  2 , Masamitsu Sugie  2 , Takashi Nishimura  7 , Akiko Kanemaru  8 , Keigo Shimoji  9 , Hirohiko Hirano  10 , Ko Furuta  11 , Akihiko Kitamura  3 , Satoshi Seino  3 , Shoji Shinkai  3 , Kazumasa Harada  2 , Shunei Kyo  7 , Hideki Ito  6 , Atsushi Araki  6
Affiliations
Observational Study

Prevalence of frailty, cognitive impairment, and sarcopenia in outpatients with cardiometabolic disease in a frailty clinic

Yoshiaki Tamura et al. BMC Geriatr. .

Abstract

Background: Although frailty and cognitive impairment are critical risk factors for disability and mortality in the general population of older inhabitants, the prevalence and incidence of these factors in individuals treated in the specialty outpatient clinics are unknown.

Methods: We recently established a frailty clinic for comprehensive assessments of conditions such as frailty, sarcopenia, and cognition, and planned 3-year prospective observational study to identify the risk factors for progression of these aging-related statuses. To date, we recruited 323 patients who revealed symptoms suggestive of frailty mainly from a specialty outpatient clinic of cardiology and diabetes. Frailty status was diagnosed by the modified Cardiovascular Health Study (mCHS) criteria and some other scales. Cognitive function was assessed by Mini-Mental State Examination (MMSE), Japanese version of the Montreal Cognitive Assessment (MoCA-J), and some other modalities. Sarcopenia was defined by the criteria of the Asian Working Group for Sarcopenia (AWGS). In this report, we outlined our frailty clinic and analyzed the background characteristics of the subjects.

Results: Most patients reported hypertension (78%), diabetes mellitus (57%), or dyslipidemia (63%), and cardiovascular disease and probable heart failure also had a higher prevalence. The prevalence of frailty diagnosed according to the mCHS criteria, cognitive impairment defined by MMSE (≤27) and MoCA-J (≤25), and of AWGS-defined sarcopenia were 24, 41, and 84, and 31%, respectively. The prevalence of frailty and cognitive impairment increased with aging, whereas the increase in sarcopenia prevalence plateaued after the age of 80 years. No significant differences were observed in the prevalence of frailty, cognitive impairment, and sarcopenia between the groups with and without diabetes mellitus, hypertension, or dyslipidemia with a few exceptions, presumably due to the high-risk subjects who had multiple cardiovascular comorbidities. A majority of the frail and sarcopenic patients revealed cognitive impairment, whereas the frequency of suspected dementia among these patients were both approximately 20%.

Conclusions: We found a high prevalence of frailty, cognitive impairment, and sarcopenia in patients with cardiometabolic disease in our frailty clinic. Comprehensive assessment of the high-risk patients could be useful to identify the risk factors for progression of frailty and cognitive decline.

Keywords: Cardiometabolic diseases; Cognitive impairment; Frailty; Frailty clinic; Modified CHS criteria; Sarcopenia.

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Conflict of interest statement

Ethics approval and consent to participate

Written informed consent was obtained from all of the participants. For some patients recognized as cognitively impaired, we obtained proxy consent from a family member or another supportive adult on their behalf. This study was approved by the ethical committee of Tokyo Metropolitan Geriatric Hospital.

Consent for publication

Not applicable

Competing interests

Araki A has received speaker honoraria from pharmaceutical companies, Merck Sharp & Dohme, Dainippon Sumitomo Parma Co. Ltd., Kyowa Hakko Kirin Co. Ltd., Astellas Pharma Inc., AstraZeneca, Astellas Pharma Inc., Tanabe Mitsubishi Pharma Corporation, Eli Lilly Japan Co. Ltd., Ono Pharmaceutical Co. Ltd., Taisho Toyama Pharmaceutical Co. Ltd., Novo Nordisk Pharma Ltd., Takeda Pharmaceutical Co. Ltd., Boehringer Ingelheim GmbH, and Novartis Pharma Co. Ltd.

zaRitz® was provided free of charge by Tanita Corp.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow chart of the recruitment of participants and assessment methods. KCL, Kihon Check List; TMIG-IC, Tokyo Metropolitan Institute of Gerontology Index of Competence; CFS, Clinical Frailty Scale; TUG, Timed Up and Go Test; MMSE, Mini-Mental State Examination; HDS-R, Revised Hasegawa’s Dementia Scale; MoCA-J, Japanese version of the Montreal Cognitive Assessment; DASC-21, Dementia Assessment Sheet in Community-based Integrated Care System-21 items; GDS-15-J, Japanese version of the Geriatric Depression Scale 15; MNA-SF, Mini-Nutritional Assessment-Short Form; LSNS-6, Lubben Social Network Scale-6
Fig. 2
Fig. 2
Frequencies of frailty, suspected dementia (MMSE score ≤ 23), cognitive impairment (MoCA-J ≤ 25), and sarcopenia stratified by age
Fig. 3
Fig. 3
Overlap of frailty, sarcopenia, and suspected dementia (MMSE score ≤ 23) (a) and overlap of frailty, sarcopenia, and cognitive impairment (MoCA-J ≤ 25) (b). Numbers indicates the number of patients included in the area
See this image and copyright information in PMC

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