Abstract
Introduction: Although arterial stiffness has been suggested to be associated with poor physical function and mild cognitive impairment (MCI), its association with cognitive frailty (CF), a comorbidity of both, is unclear. This study aims to examine the association between CF and arterial stiffness in community-dwelling older adults. Methods: A cross-sectional analysis of 511 community-dwelling older adults aged 65 years or older (mean age 73.6 ± 6.2 years, 63.6% women), who participated in a community cohort study (Tarumizu Study, 2019), was conducted. Poor physical function was defined as either slowness (walking speed <1.0 m/s) or weakness (grip strength <28 kg for men and <18 kg for women). MCI was defined by the National Center for Geriatrics and Gerontology Functional Assessment Tool as a decline of at least 1.5 standard deviation from age- and education-adjusted baseline values in any one of the four cognitive domains (memory, attention, executive, and information processing). CF was defined as the combination of poor physical function and MCI. Arterial stiffness was measured using the Cardio-Ankle Vascular Index (CAVI), and the average of the left and right sides (mean CAVI) was used. Results: Multinomial logistic regression analysis adjusted for covariates was performed with the four groups of robust, poor physical function, MCI, and CF as dependent variables and mean CAVI as an independent variable. Using the robust group as reference, the poor physical function and MCI groups showed no significant relationship with the mean CAVI. The mean CAVI was significantly higher in the CF group (odds ratio 1.62, 95% confidence interval: 1.14–2.29). Conclusion: A significant association was found between CF and the higher CAVI (progression of arterial stiffness). Careful observation and control of CAVI, which is also an indicator of arterial stiffness, may be a potential target for preventive interventions for CF.
Journal Section:
Clinical Section: Research Article
References
1.
Kelaiditi
E
, Cesari
M
, Canevelli
M
, van Kan
GA
, Ousset
PJ
, Gillette-Guyonnet
S
, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group
. J Nutr Health Aging
. 2013
;17
(9
):726
–34
. .2.
Shimada
H
, Doi
T
, Lee
S
, Makizako
H
, Chen
LK
, Arai
H
. Cognitive frailty predicts incident dementia among community-dwelling older people
. J Clin Med
. 2018
;7
(9
):250
. .3.
Bu
Z
, Huang
A
, Xue
M
, Li
Q
, Bai
Y
, Xu
G
. Cognitive frailty as a predictor of adverse outcomes among older adults: a systematic review and meta-analysis
. Brain Behav
. 2021
;11
(1
):e01926
. .4.
Qiu
Y
, Li
G
, Wang
X
, Zheng
L
, Wang
C
, Wang
C
, et al. Prevalence of cognitive frailty among community-dwelling older adults: a systematic review and meta-analysis
. Int J Nurs Stud
. 2022
;125
:104112
. .5.
Sugimoto
T
, Arai
H
, Sakurai
T
. An update on cognitive frailty: its definition, impact, associated factors and underlying mechanisms, and interventions
. Geriatr Gerontol Int
. 2022
;22
(2
):99
–109
. .6.
Robertson
DA
, Savva
GM
, Kenny
RA
. Frailty and cognitive impairment: a review of the evidence and causal mechanisms
. Ageing Res Rev
. 2013
;12
(4
):840
–51
. .7.
Panza
F
, Lozupone
M
, Solfrizzi
V
, Sardone
R
, Dibello
V
, Di Lena
L
, et al. Different cognitive frailty models and health- and cognitive-related outcomes in older age: from epidemiology to prevention
. J Alzheimers Dis
. 2018
;62
(3
):993
–1012
. .8.
Langa
KM
, Levine
DA
. The diagnosis and management of mild cognitive impairment: a clinical review
. Jama
. 2014
;312
(23
):2551
–61
. .9.
Uchikado
Y
, Ikeda
Y
, Ohishi
M
. Current understanding of the role of frailty in cardiovascular disease
. Circ J
. 2020
;84
(11
):1903
–8
. .10.
Moorman
AJ
, Dean
LS
, Yang
E
, Drezner
JA
. Cardiovascular risk assessment in the older athlete
. Sports Health
. 2021
;13
(6
):622
–9
. .11.
Shirai
K
, Utino
J
, Otsuka
K
, Takata
M
. A novel blood pressure-independent arterial wall stiffness parameter; Cardio-Ankle Vascular Index (CAVI)
. J Atheroscler Thromb
. 2006
;13
(2
):101
–7
. .12.
Townsend
RR
, Wilkinson
IB
, Schiffrin
EL
, Avolio
AP
, Chirinos
JA
, Cockcroft
JR
, et al. Recommendations for improving and standardizing vascular research on arterial stiffness: a scientific statement from the American heart association
. Hypertension
. 2015
;66
(3
):698
–722
. .13.
Matsushita
K
, Ding
N
, Kim
ED
, Budoff
M
, Chirinos
JA
, Fernhall
B
, et al. Cardio-ankle vascular index and cardiovascular disease: systematic review and meta-analysis of prospective and cross-sectional studies
. J Clin Hypertens
. 2019
;21
(1
):16
–24
. .14.
Sampaio
RA
, Sewo Sampaio
PY
, Yamada
M
, Yukutake
T
, Uchida
MC
, Tsuboyama
T
, et al. Arterial stiffness is associated with low skeletal muscle mass in Japanese community-dwelling older adults
. Geriatr Gerontol Int
. 2014
;14
(Suppl 1
):109
–14
. .15.
Xue
Q
, Qin
MZ
, Jia
J
, Liu
JP
, Wang
Y
. Association between frailty and the cardio-ankle vascular index
. Clin Interv Aging
. 2019
;14
:735
–42
. .16.
Yamamoto
N
, Yamanaka
G
, Ishikawa
M
, Takasugi
E
, Murakami
S
, Yamanaka
T
, et al. Cardio-ankle vascular index as a predictor of cognitive impairment in community-dwelling elderly people: four-year follow-up
. Dement Geriatr Cogn Disord
. 2009
;28
(2
):153
–8
. .17.
Miyoshi
T
, Ito
H
. Arterial stiffness in health and disease: the role of cardio-ankle vascular index
. J Cardiol
. 2021
;78
(6
):493
–501
. .18.
Makizako
H
, Kiyama
R
, Nakai
Y
, Kawada
M
, Tomioka
K
, Taniguchi
Y
, et al. Reference values of chair stand test and associations of chair stand performance with cognitive function in older adults
. Aging Health Res
. 2022
;2
(3
):100090
. .19.
Wada
A
, Makizako
H
, Nakai
Y
, Tomioka
K
, Taniguchi
Y
, Sato
N
, et al. Association between cognitive frailty and higher-level competence among community-dwelling older adults
. Arch Gerontol Geriatr
. 2022
;99
:104589
. .20.
Taniguchi
Y
, Makizako
H
, Nakai
Y
, Kiuchi
Y
, Akaida
S
, Tateishi
M
, et al. Associations of the alpha-actinin three genotype with bone and muscle mass loss among middle-aged and older adults
. J Clin Med
. 2022
;11
(20
):6172
. .21.
Akaida
S
, Tabira
T
, Nakai
Y
, Maruta
M
, Taniguchi
Y
, Tomioka
K
, et al. Are satisfaction and performance of meaningful activities associated with frailty in older adults
. Arch Gerontol Geriatr
. 2023
;105
:104845
. .22.
Satake
S
, Arai
H
. The revised Japanese version of the Cardiovascular Health Study criteria (revised J-CHS criteria)
. Geriatr Gerontol Int
. 2020
;20
(10
):992
–3
. .23.
Shimada
H
, Makizako
H
, Doi
T
, Yoshida
D
, Tsutsumimoto
K
, Anan
Y
, et al. Combined prevalence of frailty and mild cognitive impairment in a population of elderly Japanese people
. J Am Med Dir Assoc
. 2013
;14
(7
):518
–24
. .24.
Lee
WJ
, Peng
LN
, Liang
CK
, Loh
CH
, Chen
LK
. Cognitive frailty predicting all-cause mortality among community-living older adults in Taiwan: a 4-year nationwide population-based cohort study
. PLoS One
. 2018
;13
(7
):e0200447
. .25.
Masumitsu
T
, Kubozono
T
, Miyata
M
, Makizako
H
, Tabira
T
, Takenaka
T
, et al. Association of sleep duration and cardio-ankle vascular index in community-dwelling older adults
. J Atheroscler Thromb
. 2022
;29
(12
):1864
–71
. .26.
Tian
G
, Wei
W
, Zhang
W
, Zhang
L
, You
H
, Liu
W
, et al. Increasing age associated with elevated cardio-ankle vascular index scores in patients with type 2 diabetes mellitus
. J Int Med Res
. 2013
;41
(2
):435
–44
. .27.
Kaiser
MJ
, Bauer
JM
, Ramsch
C
, Uter
W
, Guigoz
Y
, Cederholm
T
, et al. Validation of the Mini Nutritional Assessment Short-Form (MNA®-SF): a practical tool for identification of nutritional status
. J Nutr Health Aging
. 2009
;13
(9
):782
–8
. .28.
Yesavage
JA
, Sheikh
JI
. 9/Geriatric Depression Scale (GDS): recent evidence and development of a shorter version
. Clin Gerontologist
. 1986
;5
(1–2
):165
–73
. .29.
Almeida
OP
, Almeida
SA
. Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV
. Int J Geriatr Psychiatry
. 1999
;14
(10
):858
–65
. .30.
Strandberg
TE
, Pitkälä
KH
, Tilvis
RS
, O'Neill
D
, Erkinjuntti
TJ
. Geriatric syndromes--vascular disorders
. Ann Med
. 2013
;45
(3
):265
–73
. .31.
Reid
KF
, Fielding
RA
. Skeletal muscle power: a critical determinant of physical functioning in older adults
. Exerc Sport Sci Rev
. 2012
;40
(1
):4
–12
. .32.
Yamamoto
S
, Yamaga
T
, Sakai
Y
, Ishida
T
, Nakasone
S
, Ohira
M
, et al. Association between physical performance and cardiovascular events in patients with coronary artery disease: protocol for a meta-analysis
. Syst Rev
. 2016
;5
(1
):32
. .33.
Kirkham
FA
, Bunting
E
, Fantin
F
, Zamboni
M
, Rajkumar
C
. Independent association between cardio-ankle vascular index and sarcopenia in older U.K. Adults
. J Am Geriatr Soc
. 2019
;67
(2
):317
–22
. .34.
Brady
AO
, Straight
CR
, Evans
EM
. Body composition, muscle capacity, and physical function in older adults: an integrated conceptual model
. J Aging Phys Act
. 2014
;22
(3
):441
–52
. .35.
Saji
N
, Shimizu
H
, Kawarai
T
, Tadano
M
, Kita
Y
, Yokono
K
. Increased brachial-ankle pulse wave velocity is independently associated with white matter hyperintensities
. Neuroepidemiology
. 2011
;36
(4
):252
–7
. .36.
Saji
N
, Kimura
K
, Shimizu
H
, Kita
Y
. Association between silent brain infarct and arterial stiffness indicated by brachial-ankle pulse wave velocity
. Intern Med
. 2012
;51
(9
):1003
–8
. .37.
Tap
L
, van Opbroek
A
, Niessen
WJ
, Smits
M
, Mattace-Raso
FU
. Aortic stiffness and brain integrity in elderly patients with cognitive and functional complaints
. Clin Interv Aging
. 2018
;13
:2161
–7
. .38.
Norton
S
, Matthews
FE
, Barnes
DE
, Yaffe
K
, Brayne
C
. Potential for primary prevention of Alzheimer's disease: an analysis of population-based data
. Lancet Neurol
. 2014
;13
(8
):788
–94
. .39.
Arvanitakis
Z
, Wilson
RS
, Bienias
JL
, Evans
DA
, Bennett
DA
. Diabetes mellitus and risk of Alzheimer disease and decline in cognitive function
. Arch Neurol
. 2004
;61
(5
):661
–6
. .40.
Heaw
YC
, Singh
DKA
, Tan
MP
, Kumar
S
. Bidirectional association between executive and physical functions among older adults: a systematic review
. Australas J Ageing
. 2022
;41
(1
):20
–41
. .41.
Meng
Q
, Yin
H
, Wang
S
, Shang
B
, Meng
X
, Yan
M
, et al. The effect of combined cognitive intervention and physical exercise on cognitive function in older adults with mild cognitive impairment: a meta-analysis of randomized controlled trials
. Aging Clin Exp Res
. 2022
;34
(2
):261
–76
. .42.
Saiki
A
, Sato
Y
, Watanabe
R
, Watanabe
Y
, Imamura
H
, Yamaguchi
T
, et al. The role of a novel arterial stiffness parameter, Cardio-Ankle Vascular Index (CAVI), as a surrogate marker for cardiovascular diseases
. J Atheroscler Thromb
. 2016
;23
(2
):155
–68
. .43.
Piepoli
MF
, Hoes
AW
, Agewall
S
, Albus
C
, Brotons
C
, Catapano
AL
, et al. 2016 European guidelines on cardiovascular disease prevention in clinical practice: the sixth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)
. Eur Heart J
. 2016
;37
(29
):2315
–81
. .44.
Katayama
O
, Lee
S
, Bae
S
, Makino
K
, Shinkai
Y
, Chiba
I
, et al. Lifestyle activity patterns related to physical frailty and cognitive impairment in urban community-dwelling older adults in Japan
. J Am Med Dir Assoc
. 2021
;22
(3
):583
–9
. .45.
Liu
Z
, Hsu
FC
, Trombetti
A
, King
AC
, Liu
CK
, Manini
TM
, et al. Effect of 24-month physical activity on cognitive frailty and the role of inflammation: the LIFE randomized clinical trial
. BMC Med
. 2018
;16
(1
):185
. .46.
Jiayuan
Z
, Xiang-Zi
J
, Li-Na
M
, Jin-Wei
Y
, Xue
Y
. Effects of mindfulness-based Tai chi chuan on physical performance and cognitive function among cognitive frailty older adults: a six-month follow-up of a randomized controlled trial
. J Prev Alz Dis
. 2021
;9
(1
):1
–9
. .47.
Fulop
T
, Larbi
A
, Witkowski
JM
, McElhaney
J
, Loeb
M
, Mitnitski
A
, et al. Aging, frailty and age-related diseases
. Biogerontology
. 2010
;11
(5
):547
–63
. .© 2024 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2024
You do not currently have access to this content.
