Motoric cognitive risk syndrome, physio-cognitive decline syndrome, cognitive frailty and reversibility with dual-task exercise

Cognitive frailty (CF) is associated with dementia and disability. It was initially proposed in 2013 by the International Institute of Nutrition and Aging and the International Geriatrics Association. Over the years, there have been many emerging definitions e.g., Motoric Cognitive Risk Syndrome (MC...

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Published in:Experimental gerontology 2021-07, Vol.150, p.111362-111362, Article 111362
Main Authors: Merchant, Reshma Aziz, Chan, Yiong Huak, Hui, Richard Jor Yeong, Tsoi, Chris Tung, Kwek, Sing Cheer, Tan, Weng Mooi, Lim, Jia Yi, Sandrasageran, Surein, Wong, Beatrix Ling Ling, Chen, Matthew Zhixuan, Ng, Shu Ee, Morley, John E.
Format: Article
Language:English
Subjects:
Cognitive frailty
Cognitive impairment
Dual-task exercise
Frailty
Motoric cognitive risk syndrome
Reversibility
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Summary:Cognitive frailty (CF) is associated with dementia and disability. It was initially proposed in 2013 by the International Institute of Nutrition and Aging and the International Geriatrics Association. Over the years, there have been many emerging definitions e.g., Motoric Cognitive Risk Syndrome (MCR), Physio-cognitive Decline Syndrome (PCDS), reversible CF and potentially reversible CF. Our objective was to determine the demographics including physical, functional, and psychosocial factors for the four CF definitions amongst community-dwelling older adults. In addition, the effect of dual-task exercise on the reversibility of different definitions of CF was also studied. Participants were community-dwelling older adults aged ≥60 years recruited between August 2017 and December 2019. Older adults screened to be frail, prefrail or have cognitive impairment were invited to participate in dual-task exercise program called HAPPY (Healthy Ageing Promotion Program for You). Improvement in cognition, frailty, and physical performance after a 3-month dual-task exercise intervention program was compared with controls. The prevalence of CF depending on definition ranged from 8.8% to 28.7% with minimal overlap. The cognitive scores were significantly lower in all the groups predominantly affecting non-memory domains except for reversible CF. Frailty was three to seven times more prevalent in CF. MCR group had higher prevalence of functional limitation, pain and depression. All four groups had significant increase in global cognition scores especially in the attention domain where the control group declined, and reduction in the prevalence of frailty post intervention. MCR and reversible CF were significantly associated with increased odds of cognitive improvement after 3 months of intervention compared with control. CF is a novel concept and regardless of the definitions, is a target for reversing frailty, functional limitation and cognitive impairment through dual-task exercise. Long-term prospective studies are needed to evaluate the effectiveness of dual-task interventions in delaying the conversion to dementia and reduction of disability. •Cognitive frailty (CF) is a novel target for preventing frailty and dementia.•MCR group had highest prevalence of functional limitation, pain and depression.•Dual-task exercise in CF significantly improved global cognition and attention.•MCR and reversible CF had increased odds of cognitive improvement post intervention.•There
ISSN:0531-5565
1873-6815
DOI:10.1016/j.exger.2021.111362