Affiliations: [a]
Department of Medicine, University of Montreal and Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada
| [b]
Department of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| [c]
Research Centre of the Centre Hospitalier de l’Université de Montréal, Montreal, Quebec, Canada
| [d]
Leenaards Memory Centre, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| [e]
Centre Hospitalier Universitaire de Nice, Clinique Gériatrique du Cerveau et du Mouvement, Nice, France
| [f] Laboratoire CoBTeK, Université Côte d’Azur, Nice, France
Correspondence:
[*]
Correspondence to: Olivier Beauchet, MD, PhD, Research Centre of the Geriatric University Institute of Montreal, Montreal, Quebec, Canada. Tel.: +1 514 340 3540, # 3637; Fax: +1 514 340 4765; E-mail: [email protected].
Abstract: Background:Frailty is associated with an increased risk of major neurocognitive disorders (MNCD). Objective:This study aims to compare the Fried physical model and the CARE deficit accumulation model for their association with incident major neurocognitive disorders (MNCD), and to examine how the addition of cognitive impairment to these frailty models impacts the incidence in community-dwelling older adults. Methods:A subset of community dwellers (n = 1,259) who participated in the “Quebec Longitudinal Study on Nutrition and Successful Aging” (NuAge) were selected in this Elderly population-based observational cohort study with 3 years of follow-up. Fried and CARE frailty stratifications into robust, pre-frail and frail groups were performed using the NuAge baseline assessment. Incident MNCD (i.e., Modified Mini Mental State (3MS) score < 79/100 and Instrumental Activity Daily Living (IADL) score < 6/8) were collected each year over a 3-year follow-up period. Results:A greater association with incident MNCD of the CARE frail state was observed with an increased predictive value when combined with cognitive impairment in comparison to Fried’s one, the highest incidences being observed using the robust state as the reference. Results with the Fried frail state were more heterogenous, with no association with the frail state alone, whereas cognitive impairment alone showed the highest significant incidence. Conclusion:The association of the CARE frail state with cognitive impairment increased the predictive value of MNCD, suggesting that the CARE frailty model may be of clinical interest when screening MCND in the elderly population.
