Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 16, 2024; 12(17): 3076-3085
Published online Jun 16, 2024. doi: 10.12998/wjcc.v12.i17.3076
Cardiovascular risk factors among older persons with cognitive frailty in middle income country
Azianah Mohamad Ibrahim, Devinder Kaur Ajit Singh, Arimi Fitri Mat Ludin, Noor Ibrahim Mohamed Sakian, Nurul Fatin Malek Rivan, Suzana Shahar
Azianah Mohamad Ibrahim, Devinder Kaur Ajit Singh, Arimi Fitri Mat Ludin, Nurul Fatin Malek Rivan, Suzana Shahar, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia
Noor Ibrahim Mohamed Sakian, Basic Medical Sciences, University of Cyberjaya, Selangor Darul Ehsan, Malaysia 63000, Malaysia
Author contributions: Ibrahim AM and Shahar S contributed to the first draft of the manuscript was written; and all authors commented on previous versions of the manuscript; all authors read and approved the final manuscript; all authors contributed to the study’s conception and design.
Supported by Long-term Research Grant Scheme provided by Ministry of Education Malaysia, No. LRGS/1/2019/UM-UKM/1/4; and Grand Challenge Grant Project 1 and Project 2, No. DCP-2017-002/1 and No. DCP-2017-002/2.
Institutional review board statement: The studies were approved by the Medical Research and Ethics Committee of the Universiti Kebangsaan Malaysia for LRGS TUA (UKM1.21.3/244/NN-2018=145) and AGELESS (UKM PPI/111/8/ JEP- 2020-347).
Informed consent statement: Written informed consent was obtained from all participants at baseline.
Conflict-of-interest statement: All authors declare no competing interests.
Data sharing statement: The dataset supporting the conclusions of this article is available upon request from the corresponding author.
STROBE statement: The authors have read the STROBE Statement – checklist of items, and the manuscript was prepared and revised according to the STROBE Statement – checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Suzana Shahar, PhD, Dean, Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia. suzana.shahar@ukm.edu.my
Received: January 11, 2024
Revised: February 11, 2024
Accepted: April 15, 2024
Published online: June 16, 2024
Processing time: 145 Days and 0.6 Hours
Abstract
BACKGROUND

Cognitive frailty, characterized by the coexistence of cognitive impairment and physical frailty, represents a multifaceted challenge in the aging population. The role of cardiovascular risk factors in this complex interplay is not yet fully understood.

AIM

To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia.

METHODS

A comprehensive approach was employed, with a total of 512 community-dwelling older persons aged 60 years and above, involving two cohorts of older persons from previous studies. Datasets related to cardiovascular risks, namely sociodemographic factors, and cardiovascular risk factors, including hypertension, diabetes, hypercholesterolemia, anthropometric characteristics and biochemical profiles, were pooled for analysis. Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score. Cardiovascular risk was determined using Framingham risk score. Statistical analyses were conducted using SPSS version 21.

RESULTS

Of the study participants, 46.3% exhibited cognitive frailty. Cardiovascular risk factors including hypertension (OR:1.60; 95%CI: 1.12-2.30), low fat-free mass (OR:0.96; 95%CI: 0.94-0.98), high percentage body fat (OR:1.04; 95%CI: 1.02-1.06), high waist circumference (OR:1.02; 95%CI: 1.01-1.04), high fasting blood glucose (OR:1.64; 95%CI: 1.11-2.43), high Framingham risk score (OR:1.65; 95%CI: 1.17-2.31), together with sociodemographic factors, i.e., being single (OR 3.38; 95%CI: 2.26-5.05) and low household income (OR 2.18; 95%CI: 1.44-3.30) were found to be associated with cognitive frailty.

CONCLUSION

Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty, a prodromal stage of dementia. Early identification and management of cardiovascular risk factors, particularly among specific group of the population might mitigate the risk of cognitive frailty, hence preventing dementia.

Keywords: Cognitive frailty; Older persons; Cardiovascular risk factors; Frailty; Mild cognitive impairment

Core Tip: Cognitive frailty is a concept describing a condition in older adults characterized by the simultaneous presence of physical frailty and cognitive impairment. This prodromal stage of dementia refers to the early phase where subtle cognitive changes are evident, but not yet meeting the criteria for a full diagnosis. Cardiovascular risk factors, e.g., hypertension, diabetes and high cholesterol, play a significant role in this stage. They contribute to vascular damage and compromise blood flow to the brain, increasing the risk of cognitive decline. Therefore, this study aimed to investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty.