{"title":"中国老年人身体虚弱与认知功能:日常生活限制活动与抑郁的中介作用。","authors":"C Peng, J A Burr, Y Yuan, K L Lapane","doi":"10.14283/jfa.2023.1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Physical frailty and cognitive impairment are prevalent globally, particularly in China, which is experiencing an unprecedented aging of its large population.</p><p><strong>Objectives: </strong>Examine the association between physical frailty and the level and rate of change of cognitive function, globally and by domain, among community-dwelling Chinese older adults, and quantify the mediation effects from activities of daily living (ADL) limitations and depressive symptoms.</p><p><strong>Design: </strong>Longitudinal.</p><p><strong>Setting: </strong>China Health and Retirement Longitudinal Study (2011-2018).</p><p><strong>Participants: </strong>5,431 eligible adults aged ≥ 60 years with valid information on physical frailty.</p><p><strong>Measurements: </strong>Physical frailty, cognitive function, ADL limitations, and depressive symptoms were respectively assessed by frailty phenotypes, the Telephone Interview for Cognitive Status (episodic memory, executive function, and orientation), performance in six daily tasks, and the eight-item Center for Epidemiological Studies Depression Scale. Latent growth curve models were used to address the objectives.</p><p><strong>Results: </strong>Compared to adults who were non-frail, those who were pre-frail (β = -0.06) and frail (β = -0.13) reported significantly worse global cognitive function and episodic memory (pre-frail: β = -0.05; frail: β = -0.14), executive function (pre-frail: β = -0.04, frail: β = -0.10), and orientation (pre-frail: β = -0.06; frail: β = -0.07) at baseline; those who were frail were more likely to experience faster decline in global cognitive function (β = 0.12) and episodic memory (β = 0.08). ADL limitations (β = -0.07) and depressive symptoms (β = -0.14) significantly mediated the association between physical frailty and the level of cognitive function, but not its rate of decline.</p><p><strong>Conclusions: </strong>Intervention strategies that help maintain cognitive function may benefit from early screening and assessment of physical frailty. For pre-frail and frail older Chinese adults, programs designed to help improve or maintain activities of daily living and reduce number of depressive symptoms may contribute to better cognitive performance.</p>","PeriodicalId":51629,"journal":{"name":"Journal of Frailty & Aging","volume":null,"pages":null},"PeriodicalIF":3.3000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372340/pdf/nihms-1892966.pdf","citationCount":"1","resultStr":"{\"title\":\"Physical Frailty and Cognitive Function among Older Chinese Adults: The Mediating Roles of Activities of Daily Living Limitations and Depression.\",\"authors\":\"C Peng, J A Burr, Y Yuan, K L Lapane\",\"doi\":\"10.14283/jfa.2023.1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Physical frailty and cognitive impairment are prevalent globally, particularly in China, which is experiencing an unprecedented aging of its large population.</p><p><strong>Objectives: </strong>Examine the association between physical frailty and the level and rate of change of cognitive function, globally and by domain, among community-dwelling Chinese older adults, and quantify the mediation effects from activities of daily living (ADL) limitations and depressive symptoms.</p><p><strong>Design: </strong>Longitudinal.</p><p><strong>Setting: </strong>China Health and Retirement Longitudinal Study (2011-2018).</p><p><strong>Participants: </strong>5,431 eligible adults aged ≥ 60 years with valid information on physical frailty.</p><p><strong>Measurements: </strong>Physical frailty, cognitive function, ADL limitations, and depressive symptoms were respectively assessed by frailty phenotypes, the Telephone Interview for Cognitive Status (episodic memory, executive function, and orientation), performance in six daily tasks, and the eight-item Center for Epidemiological Studies Depression Scale. Latent growth curve models were used to address the objectives.</p><p><strong>Results: </strong>Compared to adults who were non-frail, those who were pre-frail (β = -0.06) and frail (β = -0.13) reported significantly worse global cognitive function and episodic memory (pre-frail: β = -0.05; frail: β = -0.14), executive function (pre-frail: β = -0.04, frail: β = -0.10), and orientation (pre-frail: β = -0.06; frail: β = -0.07) at baseline; those who were frail were more likely to experience faster decline in global cognitive function (β = 0.12) and episodic memory (β = 0.08). ADL limitations (β = -0.07) and depressive symptoms (β = -0.14) significantly mediated the association between physical frailty and the level of cognitive function, but not its rate of decline.</p><p><strong>Conclusions: </strong>Intervention strategies that help maintain cognitive function may benefit from early screening and assessment of physical frailty. For pre-frail and frail older Chinese adults, programs designed to help improve or maintain activities of daily living and reduce number of depressive symptoms may contribute to better cognitive performance.</p>\",\"PeriodicalId\":51629,\"journal\":{\"name\":\"Journal of Frailty & Aging\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372340/pdf/nihms-1892966.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Frailty & Aging\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.14283/jfa.2023.1\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Frailty & Aging","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14283/jfa.2023.1","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Physical Frailty and Cognitive Function among Older Chinese Adults: The Mediating Roles of Activities of Daily Living Limitations and Depression.
Background: Physical frailty and cognitive impairment are prevalent globally, particularly in China, which is experiencing an unprecedented aging of its large population.
Objectives: Examine the association between physical frailty and the level and rate of change of cognitive function, globally and by domain, among community-dwelling Chinese older adults, and quantify the mediation effects from activities of daily living (ADL) limitations and depressive symptoms.
Design: Longitudinal.
Setting: China Health and Retirement Longitudinal Study (2011-2018).
Participants: 5,431 eligible adults aged ≥ 60 years with valid information on physical frailty.
Measurements: Physical frailty, cognitive function, ADL limitations, and depressive symptoms were respectively assessed by frailty phenotypes, the Telephone Interview for Cognitive Status (episodic memory, executive function, and orientation), performance in six daily tasks, and the eight-item Center for Epidemiological Studies Depression Scale. Latent growth curve models were used to address the objectives.
Results: Compared to adults who were non-frail, those who were pre-frail (β = -0.06) and frail (β = -0.13) reported significantly worse global cognitive function and episodic memory (pre-frail: β = -0.05; frail: β = -0.14), executive function (pre-frail: β = -0.04, frail: β = -0.10), and orientation (pre-frail: β = -0.06; frail: β = -0.07) at baseline; those who were frail were more likely to experience faster decline in global cognitive function (β = 0.12) and episodic memory (β = 0.08). ADL limitations (β = -0.07) and depressive symptoms (β = -0.14) significantly mediated the association between physical frailty and the level of cognitive function, but not its rate of decline.
Conclusions: Intervention strategies that help maintain cognitive function may benefit from early screening and assessment of physical frailty. For pre-frail and frail older Chinese adults, programs designed to help improve or maintain activities of daily living and reduce number of depressive symptoms may contribute to better cognitive performance.
期刊介绍：
The Journal of Frailty & Aging is a peer-reviewed international journal aimed at presenting articles that are related to research in the area of aging and age-related (sub)clinical conditions. In particular, the journal publishes high-quality papers describing and discussing social, biological, and clinical features underlying the onset and development of frailty in older persons. The Journal of Frailty & Aging is composed by five different sections: - Biology of frailty and aging In this section, the journal presents reports from preclinical studies and experiences focused at identifying, describing, and understanding the subclinical pathophysiological mechanisms at the basis of frailty and aging. - Physical frailty and age-related body composition modifications Studies exploring the physical and functional components of frailty are contained in this section. Moreover, since body composition plays a major role in determining physical frailty and, at the same time, represents the most evident feature of the aging process, special attention is given to studies focused on sarcopenia and obesity at older age. - Neurosciences of frailty and aging The section presents results from studies exploring the cognitive and neurological aspects of frailty and age-related conditions. In particular, papers on neurodegenerative conditions of advanced age are welcomed. - Frailty and aging in clinical practice and public health This journal’s section is devoted at presenting studies on clinical issues of frailty and age-related conditions. This multidisciplinary section particularly welcomes reports from clinicians coming from different backgrounds and specialties dealing with the heterogeneous clinical manifestations of advanced age. Moreover, this part of the journal also contains reports on frailty- and age-related social and public health issues. - Clinical trials and therapeutics This final section contains all the manuscripts presenting data on (pharmacological and non-pharmacological) interventions aimed at preventing, delaying, or treating frailty and age-related conditions.The Journal of Frailty & Aging is a quarterly publication of original papers, review articles, case reports, controversies, letters to the Editor, and book reviews. Manuscripts will be evaluated by the editorial staff and, if suitable, by expert reviewers assigned by the editors. The journal particularly welcomes papers by researchers from different backgrounds and specialities who may want to share their views and experiences on the common themes of frailty and aging.The abstracting and indexing of the Journal of Frailty & Aging is covered by MEDLINE (approval by the National Library of Medicine in February 2016).
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