Cognitive Prefrail and Frailty, and Motoric Cognitive Risk Syndrome: Prevalence and Association With Incident Adverse Health Events

Recruiting in Palo Alto (17 mi)

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Waitlist Available

Sponsor: Jewish General Hospital

No Placebo Group

Trial Summary

What is the purpose of this trial?

We defined a new and early condition in the spectrum of cognitive frailty: the "cognitive-prefrailty" which is a combination of prefrailty stage and subjective cognitive impairment (SCI). This study aims to: (1) examine and compare the prevalence of cognitive-prefrailty, cognitive frailty and motoric cognitive risk syndrome (MCR) syndromes in participants of the Canadian Longitudinal Study of Aging (CLSA) using the (tracking and comprehensive) baseline assessment, (2) examine the association of cognitive-prefrailty, cognitive frailty and MCR syndromes with incident adverse health events using the information collected during the first CLSA 18-month follow-up, and (3) compare the criteria performances (i.e., sensitivity, specificity, positive predictive value, negative predictive value, area under receiver operating characteristic curve, positive and negative likelihood ratio) for incident adverse health events of the cognitive-prefrailty, cognitive frailty and MCR syndromes.

Eligibility Criteria

Inclusion Criteria

participants of the CLSA with baseline assessment (tracking and comprehensive assessment) and first 18-month follow-up assessment

age > 50

Treatment Details

Interventions

Data Collection (Other)

Participant Groups

3Treatment groups

Experimental Treatment

Group I: Individuals with prefrailtyExperimental Treatment1 Intervention

This is defined as a co-existing prefrailty using the Fried criteria. Frailty defined by the CHS index as proposed by Fried et al. will be identified by the presence of ≥ 3 of the following 5 components: 1) Shrinking: unintentional weight loss of ≥ 5% between two assessments, 2) Weakness: a maximal grip strength in the lowest quintile stratified by body mass index quartile; 3) Poor energy: answer of "no" to the question "Do you feel full of energy?" from the 15-item Geriatric Depression Scale; 4) Slowness: average walk speed in the lowest quintile stratified by median standing height, and 5) Low physical activity level: PASE score in the lowest quintile. Participants with none of the above components will be considered to be vigorous and those with 1 or 2 components will be considered to be in a prefrail stage.

Group II: Individuals with cognitive-prefrailtyExperimental Treatment1 Intervention

A combination of prefrailty stage using Fried criteria and subjective cognitive impairment (SCI). The IANA/IAGG consensus defines cognitive frailty as CDR = 0.5 and frailty by the Fried criteria. In this study, an individual will be considered a CHI if they meet the following criteria: no history of dementia, no use of anti-dementia drugs, normal cognitive performance on cognitive tests and normal scores of ADL and IADL scales. Different participant subgroups will be identified: 1) Individuals will be classified as MCI if they meet the following criteria: Objective cognitive impairment (i.e., performance between 1.5 and 1.9 SDs below the age-appropriate mean) in one or two cognitive domains (i.e., episodic memory and/or executive function) and normal scores of ADL and IADL scales; 2) Individuals will be considered older adults with mild-stage major neurocognitive disorders

Group III: Individuals with MCRExperimental Treatment1 Intervention

The diagnosis of MCR syndrome will be made following the criteria of Verghese et al. 5: a combination of subjective cognitive complaint, in particular of memory complaint, with the presence of an objective slow gait and the absence of dementia or mobility disability. MCR syndrome will be defined at baseline assessment and each year of follow-up period. Slow gait speed will be defined as gait speed that is one standard deviation (SD) or more below age-and sex-appropriate mean values established in the present cohort like in previous studies. The mean value and SD of female and male will be determined separately. Gait speed was determined from the 3-meter walking test using the best time of the two trials recorded and expressed as meters per second. Memory complaint used to define MCR syndrome was based on standardized memory loss question on the 15-item Geriatric Depression Scale (GDS; "Do you feel you have more problems with memory than most?").