Fragilidad cognitiva, un desafío en evolución
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jun 25, 2019
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Resumen
Dentro de los principales desafíos relacionados con el envejecimiento se encuentran la fragilidad y el deterioro cognitivo, condiciones que se han relacionado con aumento en la declinación funcional, la discapacidad y el deterioro en la calidad de vida. Durante los últimos años se ha demostrado la relación bidireccional entre estas dos condiciones clínicas y dentro del Grupo de Consenso Internacional en Toulouse, Francia, surgió el término fragilidad cognitiva, en el 2013. Ese estado reversible se ha considerado un nuevo síndrome geriátrico, caracterizado por la coexistencia entre fragilidad física y deterioro cognitivo; sin embargo, aún sin criterios diagnósticos definidos. El objetivo es realizar una aproximación de la definición, fisiopatología, herramientas diagnósticas y su respectiva asociación con desenlaces adversos, para realizar un diagnóstico oportuno y aplicar intervenciones multidominio centradas en la actividad física, el enfoque nutricional y el entrenamiento cognitivo, que puedan modificar el curso de este estado dinámico y reversible, previniendo el deterioro funcional y mejorando la calidad de vida de las personas mayores.
Keywords
frailty, memory, motility, elderly, cognition.fragilidad, cognición, adulto mayor, anciano, movilidad, memoria
References
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2. Dulcey E, Arrubla D, Sanabria P. Envejecimiento y vejez en Colombia. Vol. 6. Bogotá: Profamilia Colombia; 2013.
3. Hidenori A, Stake S, Kozaki K. Cognitive frailty in geriatrics aging frailty mild cognitive impairment dementia disability exercise. Clin Geriatr Med. 2018;34(4):667-75.
4. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752-62.
5. Morley J, Vellas B, Kan G van, Anker S. Frailty consensus: a call to action. J Am. 2013;14(6):392-7.
6. American Psychiatric Association. DSM-5: Manual diagnóstico y estadístico de los trastornos mentales. 5a ed. Madrid: Editorial Médica Panamericana; 2014. p. 319-37.
7. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Ser A Biol Sci Med Sci. 2001;56(3):M146-57.
8. Rockwood K, Bergman H. Frailty: a report from the 3rd Joint Workshop of IAGG/WHO/SFGG, Athens, January 2012. Can Geriatr J. 2012;15(2):31-6.
9. Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A/I.A.G.G) International consensus group. J Nutr Heal Aging. 2013;17(9):726-34.
10. Feng L, Zin Nyunt MS, Gao Q, et al. Cognitive frailty and adverse health outcomes: findings from the Singapore Longitudinal Ageing Studies (SLAS). J Am Med Dir Assoc. 2017;18(3):252-8.
11. Solfrizzi V, Scafato E, Lozupone M, et al. Additive role of a potentially reversible cognitive frailty model and inflammatory state on the risk of disability: the Italian Longitudinal Study on Aging. Am J Geriatr Psychiatry. 2017;25(11):1236-48.
12. Morley JE. Cognitive frailty: a new geriatric syndrome? Eur Geriatr Med. 2015;6(5):408-11.
13. Paganini-Hill A, Clark LJ, Henderson V, Birge S. Clock drawing: analysis in a retirement community. J Am Geriatr Soc. 2001;49(7):941-7.
14. Panza F, Solfrizzi V, Barulli MR, et al. Cognitive frailty - epidemiological and neurobiological evidence of an age-related clinical condition: a systematic review. Rejuvenation Res. 2015;18(5):389-412.
15. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012;60(8):1487-92.
16. Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: A clinical review. JAMA. 2014;312(23):2551-61.
17. Shimada H, Makizako H, Lee S, et al. Impact of cognitive frailty on daily activities in older persons. J Nutr Heal Aging. 2016;20(7):729-35.
18. Roppolo M, Mulasso A, Rabaglietti E. Cognitive frailty in italian community-dwelling older adults: Prevalence rate and its association with disability. J Nutr Health Aging. 2017;21(6):631-6.
19. Lee Y, Kim J, Chon D, Lee KE, Kim JH, Myeong S, et al. The effects of frailty and cognitive impairment on 3-year mortality in older adults. Maturitas. 2018;107:50-5.
20. Mulero J, Zafrilla P, Martinez-Cacha A. Oxidative stress, frailty and cognitive decline. J Nutr Health Aging. 2011;15(9):756-60.
21. Liang F, Kume S, Koya D. SIRT1 and insulin resistance. Nat Rev Endocrinol. 2009;5(7):367-73.
22. Hsieh T, Chang H, Wu I, et al. Independent association between subjective cognitive decline and frailty in the elderly. PLoS One. 2018;13(8):1-12.
23. Yaffe K, Lindquist K, Penninx BW, et al. Inflammatory markers and cognition in well-functioning African-American and white elders. Neurology. 2003;61(1):76-80.
24. Hubbard RE, Woodhouse KW. Frailty, inflammation and the elderly. Biogerontology. 2010;11:635-41.
25. Michaud M, Balardy L, Moulis G, et al. Proinflammatory cytokines, aging, and age-related diseases. J Am Med Dir Assoc. 2013;14(12):877-82.
26. Collerton J, Martin-ruiz C, Davies K, et al. Frailty and the role of inflammation, immunosenescence and cellular ageing in the very old: Cross-sectional findings from the Newcastle 85 + Study. Mech Ageing Dev. 2012;133(6):456-66.
27. Fougère B, Delrieu J, del Campo N, et al. Cognitive frailty: mechanisms, tools to measure, prevention and controversy. Clin Geriatr Med. 2017;33(3):339-55.
28. Mulero J, Zafrilla P, Martínez-Cacha A. Oxidative stress, frailty and cognitive decline. J Nutr Health Aging. 2011;15(9):756-60.
29. Ershler WB, Keller ET. Age-associated increased interleukin-6 gene expression, late-life disease, and frailty. Annu Rev Med. 2000;51:245-70.
30. Delrieu J, Andrieu S, Pahor M, et al. Neuropsychological profile of “cognitive frailty” subjects in MAPT Study. J Prev Alzheimers Dis. 2016;3(3):151-9.
31. del Campo N, Payoux P, Djilali A, et al. Relationship of regional brain b-amyloid to gait speed. Am Acad Neurol. 2015;86:1-8.
32. Yoon DH, Lee J-Y, Shin SA, Kim YK, Song W. Physical frailty and amyloid-β deposits in the brains of older adults with cognitive frailty. J Clin Med. 2018;7(169):1-12.
33. Gómez-Isla T, Hollister R, West H, et al. Neurond loss correlates with but exceeds neurofibrillary tangles in Alzheimer’s disease. Am Neurol Assoc. 1997;41:17-24.
34. Chainani V, Riehl R, Chainani G, et al. Frailty and cardiovascular disease. En: Frailty and sarcopenia-onset, development and clinical challenges. Intech Open [internet]; 2017. p. 196-209. https://doi.org/10.5772/65153.
35. Sinclair AJ, Rodriguez-Mañas L. Diabetes and frailty: two converging conditions? Can J Diabetes. 2016;40(1):77-83.
36. Feng L, Roiland R, Chen DD, Qiu C. Linking cognition and frailty in middle and old age: metabolic syndrome matters. Int J Geriatr Psychiatry. 2015;30:64-71.
37. Barzilay JI, Blaum C, Moore T, et al. Insulin resistance and inflammation as precursors of frailty. Arch Intern Med. 2007;167:635-41.
38. Varadhan R, Walston J, Cappola AR, et al. Higher levels and blunted diurnal variation of cortisol in frail older women. J Gerontol Med Sci. 2008;63(2):190-5.
39. Azzopardi RV, Beyer I, Vermeiren S, et al. Increasing use of cognitive measures in the operational definition of frailty: A systematic review. Ageing Res Rev. 2018;43:10-6.
40. Muller M, Grobbee D, Thijssen J, van den Beld A, van der Schouw Y. Sex hormones and male health: effects on components of the frailty syndrome. Trends Endocrinol Metab. 2003;14(6):289-96.
41. Rockwood K, Stadnyk K, MacKnight C, et al. A brief clinical instrument to classify frailty in elderly people. Lancet. 1999;353(9148):205-6.
42. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J. 2005;173(5):489-95.
43. van Kan G, Rolland Y, Bergman H, et al. The I.A.N.A. Task force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008;12(1):29-37.
44. van Kan GA, Rolland YM, Morley JE, Vellas B. Frailty: toward a clinical definition. J Am Med Dir Assoc. 2008;9(2):71-2.
45. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged african americans. J Nutr Heal Aging. 2012;16(7):601-8.
46. Gobbens RJJ, Luijkx KG, Wijnen-Sponselee MT, Schols JMG. Towards an integral conceptual model of frailty. J Nutr Health Aging. 2010;14(3):175-81.
47. Gómez JF, Curcio C-L, Alvarado B, Zunzunegui MV, Guralnik J. Validity and reliability of the Short Physical Performance Battery (SPPB): a pilot study on mobility in the Colombian Andes. Colomb Med. 2013;44(3):165-71.
48. Wennie Huang WN, Perera S, Vanswearingen J, Studenski S. Performance measures predict onset of activity of daily living difficulty in community-dwelling older adults. J Am Geriatr Soc. 2010;58(5):844-52.
49. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332(9):556-62.
50. Gil Gregorio P. Evaluación clínica y herramientas diagnósticas. Rev Esp Geriatr Gerontol. 2017;52(Supl 1):34-8.
51. Abdulrab K, Heun R. Subjective memory impairment: a review of its definitions indicates the need for a comprehensive set of standardised and validated criteria. Eur Psychiatry. 2008;23(5):321-30.
52. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566-72.
53. Won CW, Lee Y, Kim S, Yoo J, Kim M, Ng T-P, et al. Modified criteria for diagnosing “cognitive frailty“. Psychiatry Investig. 2018;15(9):839-42.
54. Dedeyne L, Deschodt M, Vershueren S, Tournoy J, Gielen E. Effects of multi-domain interventions in (pre) frail elderly on frailty, functional, and cognitive status: a systematic review. Clin Interv un Aging. 2017;12:873-96.
55. Gómez Pavón J, Alcaraz López C, Cristoffori G, Aguado R, Ares Conde B. Concepto de fragilidad: detección y tratamiento. Tipología del paciente anciano. Valoración geriátrica integral y criterios de calidad asistencial. Medicine. 2018;12(62):3627-90.
56. Talegawkar SA, Bandinelli S, Bandeen-roche K, et al. A Higher Adherence to a mediterranean-style diet is inversely associated with the development of frailty in community-dwelling elderly men and women. J Nutr. 2012;142(12):2161-6.
57. Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255-63.
2. Dulcey E, Arrubla D, Sanabria P. Envejecimiento y vejez en Colombia. Vol. 6. Bogotá: Profamilia Colombia; 2013.
3. Hidenori A, Stake S, Kozaki K. Cognitive frailty in geriatrics aging frailty mild cognitive impairment dementia disability exercise. Clin Geriatr Med. 2018;34(4):667-75.
4. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet. 2013;381(9868):752-62.
5. Morley J, Vellas B, Kan G van, Anker S. Frailty consensus: a call to action. J Am. 2013;14(6):392-7.
6. American Psychiatric Association. DSM-5: Manual diagnóstico y estadístico de los trastornos mentales. 5a ed. Madrid: Editorial Médica Panamericana; 2014. p. 319-37.
7. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol Ser A Biol Sci Med Sci. 2001;56(3):M146-57.
8. Rockwood K, Bergman H. Frailty: a report from the 3rd Joint Workshop of IAGG/WHO/SFGG, Athens, January 2012. Can Geriatr J. 2012;15(2):31-6.
9. Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A/I.A.G.G) International consensus group. J Nutr Heal Aging. 2013;17(9):726-34.
10. Feng L, Zin Nyunt MS, Gao Q, et al. Cognitive frailty and adverse health outcomes: findings from the Singapore Longitudinal Ageing Studies (SLAS). J Am Med Dir Assoc. 2017;18(3):252-8.
11. Solfrizzi V, Scafato E, Lozupone M, et al. Additive role of a potentially reversible cognitive frailty model and inflammatory state on the risk of disability: the Italian Longitudinal Study on Aging. Am J Geriatr Psychiatry. 2017;25(11):1236-48.
12. Morley JE. Cognitive frailty: a new geriatric syndrome? Eur Geriatr Med. 2015;6(5):408-11.
13. Paganini-Hill A, Clark LJ, Henderson V, Birge S. Clock drawing: analysis in a retirement community. J Am Geriatr Soc. 2001;49(7):941-7.
14. Panza F, Solfrizzi V, Barulli MR, et al. Cognitive frailty - epidemiological and neurobiological evidence of an age-related clinical condition: a systematic review. Rejuvenation Res. 2015;18(5):389-412.
15. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc. 2012;60(8):1487-92.
16. Langa KM, Levine DA. The diagnosis and management of mild cognitive impairment: A clinical review. JAMA. 2014;312(23):2551-61.
17. Shimada H, Makizako H, Lee S, et al. Impact of cognitive frailty on daily activities in older persons. J Nutr Heal Aging. 2016;20(7):729-35.
18. Roppolo M, Mulasso A, Rabaglietti E. Cognitive frailty in italian community-dwelling older adults: Prevalence rate and its association with disability. J Nutr Health Aging. 2017;21(6):631-6.
19. Lee Y, Kim J, Chon D, Lee KE, Kim JH, Myeong S, et al. The effects of frailty and cognitive impairment on 3-year mortality in older adults. Maturitas. 2018;107:50-5.
20. Mulero J, Zafrilla P, Martinez-Cacha A. Oxidative stress, frailty and cognitive decline. J Nutr Health Aging. 2011;15(9):756-60.
21. Liang F, Kume S, Koya D. SIRT1 and insulin resistance. Nat Rev Endocrinol. 2009;5(7):367-73.
22. Hsieh T, Chang H, Wu I, et al. Independent association between subjective cognitive decline and frailty in the elderly. PLoS One. 2018;13(8):1-12.
23. Yaffe K, Lindquist K, Penninx BW, et al. Inflammatory markers and cognition in well-functioning African-American and white elders. Neurology. 2003;61(1):76-80.
24. Hubbard RE, Woodhouse KW. Frailty, inflammation and the elderly. Biogerontology. 2010;11:635-41.
25. Michaud M, Balardy L, Moulis G, et al. Proinflammatory cytokines, aging, and age-related diseases. J Am Med Dir Assoc. 2013;14(12):877-82.
26. Collerton J, Martin-ruiz C, Davies K, et al. Frailty and the role of inflammation, immunosenescence and cellular ageing in the very old: Cross-sectional findings from the Newcastle 85 + Study. Mech Ageing Dev. 2012;133(6):456-66.
27. Fougère B, Delrieu J, del Campo N, et al. Cognitive frailty: mechanisms, tools to measure, prevention and controversy. Clin Geriatr Med. 2017;33(3):339-55.
28. Mulero J, Zafrilla P, Martínez-Cacha A. Oxidative stress, frailty and cognitive decline. J Nutr Health Aging. 2011;15(9):756-60.
29. Ershler WB, Keller ET. Age-associated increased interleukin-6 gene expression, late-life disease, and frailty. Annu Rev Med. 2000;51:245-70.
30. Delrieu J, Andrieu S, Pahor M, et al. Neuropsychological profile of “cognitive frailty” subjects in MAPT Study. J Prev Alzheimers Dis. 2016;3(3):151-9.
31. del Campo N, Payoux P, Djilali A, et al. Relationship of regional brain b-amyloid to gait speed. Am Acad Neurol. 2015;86:1-8.
32. Yoon DH, Lee J-Y, Shin SA, Kim YK, Song W. Physical frailty and amyloid-β deposits in the brains of older adults with cognitive frailty. J Clin Med. 2018;7(169):1-12.
33. Gómez-Isla T, Hollister R, West H, et al. Neurond loss correlates with but exceeds neurofibrillary tangles in Alzheimer’s disease. Am Neurol Assoc. 1997;41:17-24.
34. Chainani V, Riehl R, Chainani G, et al. Frailty and cardiovascular disease. En: Frailty and sarcopenia-onset, development and clinical challenges. Intech Open [internet]; 2017. p. 196-209. https://doi.org/10.5772/65153.
35. Sinclair AJ, Rodriguez-Mañas L. Diabetes and frailty: two converging conditions? Can J Diabetes. 2016;40(1):77-83.
36. Feng L, Roiland R, Chen DD, Qiu C. Linking cognition and frailty in middle and old age: metabolic syndrome matters. Int J Geriatr Psychiatry. 2015;30:64-71.
37. Barzilay JI, Blaum C, Moore T, et al. Insulin resistance and inflammation as precursors of frailty. Arch Intern Med. 2007;167:635-41.
38. Varadhan R, Walston J, Cappola AR, et al. Higher levels and blunted diurnal variation of cortisol in frail older women. J Gerontol Med Sci. 2008;63(2):190-5.
39. Azzopardi RV, Beyer I, Vermeiren S, et al. Increasing use of cognitive measures in the operational definition of frailty: A systematic review. Ageing Res Rev. 2018;43:10-6.
40. Muller M, Grobbee D, Thijssen J, van den Beld A, van der Schouw Y. Sex hormones and male health: effects on components of the frailty syndrome. Trends Endocrinol Metab. 2003;14(6):289-96.
41. Rockwood K, Stadnyk K, MacKnight C, et al. A brief clinical instrument to classify frailty in elderly people. Lancet. 1999;353(9148):205-6.
42. Rockwood K, Song X, MacKnight C, et al. A global clinical measure of fitness and frailty in elderly people. Can Med Assoc J. 2005;173(5):489-95.
43. van Kan G, Rolland Y, Bergman H, et al. The I.A.N.A. Task force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008;12(1):29-37.
44. van Kan GA, Rolland YM, Morley JE, Vellas B. Frailty: toward a clinical definition. J Am Med Dir Assoc. 2008;9(2):71-2.
45. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged african americans. J Nutr Heal Aging. 2012;16(7):601-8.
46. Gobbens RJJ, Luijkx KG, Wijnen-Sponselee MT, Schols JMG. Towards an integral conceptual model of frailty. J Nutr Health Aging. 2010;14(3):175-81.
47. Gómez JF, Curcio C-L, Alvarado B, Zunzunegui MV, Guralnik J. Validity and reliability of the Short Physical Performance Battery (SPPB): a pilot study on mobility in the Colombian Andes. Colomb Med. 2013;44(3):165-71.
48. Wennie Huang WN, Perera S, Vanswearingen J, Studenski S. Performance measures predict onset of activity of daily living difficulty in community-dwelling older adults. J Am Geriatr Soc. 2010;58(5):844-52.
49. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332(9):556-62.
50. Gil Gregorio P. Evaluación clínica y herramientas diagnósticas. Rev Esp Geriatr Gerontol. 2017;52(Supl 1):34-8.
51. Abdulrab K, Heun R. Subjective memory impairment: a review of its definitions indicates the need for a comprehensive set of standardised and validated criteria. Eur Psychiatry. 2008;23(5):321-30.
52. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566-72.
53. Won CW, Lee Y, Kim S, Yoo J, Kim M, Ng T-P, et al. Modified criteria for diagnosing “cognitive frailty“. Psychiatry Investig. 2018;15(9):839-42.
54. Dedeyne L, Deschodt M, Vershueren S, Tournoy J, Gielen E. Effects of multi-domain interventions in (pre) frail elderly on frailty, functional, and cognitive status: a systematic review. Clin Interv un Aging. 2017;12:873-96.
55. Gómez Pavón J, Alcaraz López C, Cristoffori G, Aguado R, Ares Conde B. Concepto de fragilidad: detección y tratamiento. Tipología del paciente anciano. Valoración geriátrica integral y criterios de calidad asistencial. Medicine. 2018;12(62):3627-90.
56. Talegawkar SA, Bandinelli S, Bandeen-roche K, et al. A Higher Adherence to a mediterranean-style diet is inversely associated with the development of frailty in community-dwelling elderly men and women. J Nutr. 2012;142(12):2161-6.
57. Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255-63.
Cómo citar
Chacón-Valenzuela, E., Morros-González, E., Vargas-Beltrán, M. P., Venegas-Sanabria, L. C., Gómez-Arteaga, R. C., Chavarro-Carvajal, D., & Cano-Gutiérrez, C. A. (2019). Fragilidad cognitiva, un desafío en evolución. Universitas Medica, 60(3), 1–11. https://doi.org/10.11144/Javeriana.umed60-3.fcde
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