Haiyang Yan, Jingjing Lang, Chengfeng Li, Samaneh Eftekhariranjbar, Guoyan Jiang, Jing Lei, Lixin Sun, Carlos J. Toro-Huamanchumo, Zhongyang Guan
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引用次数: 0
Abstract
Background
Cognitive frailty, a novel construct integrating cognitive and physical deficits, is increasingly recognized in aging research.
Aims
This study aimed to examine the associations between cognitive frailty and cardiometabolic risk in two nationally representative cohorts from China and the United Kingdom.
Methods
We analyzed data from 7,628 participants in the China Health and Retirement Longitudinal Study (CHARLS) and 4,703 participants from the English Longitudinal Study of Ageing (ELSA), all aged ≥ 50 years. Frailty was assessed using the frailty index (FI) in the main analysis. Cox proportional hazards models were applied to estimate hazard ratios (HRs) for incident cardiometabolic diseases (CMDs), cardiovascular diseases (CVDs), and diabetes. Subgroup and interaction analyses were performed to examine effect modification. Restricted cubic spline (RCS) models were used to assess the shape of the association between FI and cardiometabolic risk. Sensitivity analyses employed competing risk models and the physical frailty phenotype (PFP) as an alternative frailty measure.
Results
Cognitive frailty was associated with higher risks of CMDs (HR 1.58, 95% CI 1.39–1.79), CVDs (HR 1.64, 95% CI 1.42–1.89), and diabetes (HR 1.39, 95% CI 1.11–1.75). Cognitive impairment alone showed no significant association with these outcomes in the main analysis. Dose–response associations were significant between the FI and CMDs and CVDs among individuals with and without cognitive impairment. Results were consistent across cohorts and robust in sensitivity analyses.
Conclusions
Cognitive frailty is a consistent predictor of cardiometabolic risk across distinct populations, supporting integrated screening and prevention strategies targeting both cognitive and physical deficits in aging populations.
认知脆弱是一种整合认知和生理缺陷的新概念，在老龄化研究中越来越受到重视。本研究旨在研究来自中国和英国的两个具有全国代表性的队列中认知衰弱和心脏代谢风险之间的关系。方法我们分析了中国健康与退休纵向研究（CHARLS）的7628名参与者和英国老龄化纵向研究（ELSA）的4703名参与者的数据，这些参与者的年龄均≥50岁。在主分析中，用衰弱指数（FI）评价衰弱程度。应用Cox比例风险模型估计心血管代谢疾病（CMDs）、心血管疾病（cvd）和糖尿病的风险比（hr）。进行亚组分析和相互作用分析以检验效果的改变。使用限制性三次样条（RCS）模型来评估FI与心脏代谢风险之间的关系。敏感性分析采用竞争风险模型和体质脆弱表型（PFP）作为另一种脆弱性测量方法。结果认知衰弱与心血管疾病（HR 1.58, 95% CI 1.39 - 1.79）、心血管疾病（HR 1.64, 95% CI 1.42-1.89）和糖尿病（HR 1.39, 95% CI 1.11-1.75）的高风险相关。在主要分析中，单独的认知障碍与这些结果没有显著的关联。在有和没有认知障碍的个体中，FI与cvd和cvd之间存在显著的剂量-反应关联。结果在整个队列中是一致的，在敏感性分析中是稳健的。结论认知衰弱是不同人群心脏代谢风险的一致预测因子，支持针对老年人群认知和身体缺陷的综合筛查和预防策略。
期刊介绍：
Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.
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