Relationship between cognition and frailty in elderly: A systematic
               review

Brigola, Allan Gustavo; Rossetti, Estefani Serafim; Santos, Bruna Rodrigues dos; Neri, Anita Liberalesso; Zazzetta, Marisa Silvana; Inouye, Keika; Pavarini, Sofia Cristina Iost

doi:10.1590/1980-57642015DN92000005

Allan Gustavo Brigola

Bacharel, Mestrando do Programa de Pós Graduação em Enfermagem da Universidade Federal de São Carlos

Estefani Serafim Rossetti

Bacharel, Mestrando do Programa de Pós Graduação em Enfermagem da Universidade Federal de São Carlos

Bruna Rodrigues dos Santos

Graduando em Gerontologia da Universidade Federal de São Carlos

Anita Liberalesso Neri

Professor Doutor, Docente do Programa de Pós Graduação em Gerontologia da Faculdade de Ciências Médicas da Universidade Estadual de Campinas

Marisa Silvana Zazzetta

Professor Doutor, Docente do Departamento de Gerontologia da Universidade Federal de São Carlos

Keika Inouye

Professor Doutor, Docente do Departamento de Gerontologia da Universidade Federal de São Carlos

Sofia Cristina Iost Pavarini

Professor Doutor, Docente do Departamento de Gerontologia da Universidade Federal de São Carlos

Allan Gustavo Brigola. Rua Urias Cardoso de Toledo, 133 - 13563-528 São Carlos SP - Brasil. E-mail: allanbrig@gmail.com

Author contributions. Allan Gustavo Brigola - Delimitação do tema, delimitação dos métodos, busca de artigos, análise e interpretação dos dados, redação, revisão crítica e aprovação final. Estefani Serafim Rossetti - Delimitação do tema, delimitação dos métodos, busca de artigos, análise e interpretação dos dados, redação, revisão crítica e aprovação final. Bruna Rodrigues dos Santos - Delimitação do tema, delimitação dos métodos, redação, revisão crítica e aprovação final. Anita Liberalesso Neri - Delimitação do tema, delimitação dos métodos, redação, revisão crítica e aprovação final. Marisa Silvana Zazzetta - Delimitação do tema, delimitação dos métodos, redação, revisão crítica e aprovação final. Keika Inouye - Delimitação do tema, delimitação dos métodos, redação, revisão crítica e aprovação final. Sofia Cristina Iost Pavarini - Delimitação do tema, delimitação dos métodos, redação, revisão crítica e aprovação final.

Disclosure: The authors report no conflicts of interest

Study	Place	Demographics	Frailty measurement	Cognition measurement	Principal findings
Ávila-Funes et al. (2011)	Mexico City, Mexico	N=475 Age: 78.1 53.9% female	Fried et al. criteria	MMSE Isaacs Set Test	16% CI Frailty was associated with cognitive impairment, however without statistical significance (p=0.063)
Han, Lee, Kim (2013)	Twenty-five regions, South Korea	N=10388 Age: 65+ 58.9% female	Fried et al. criteria	MMSE	22.1% CI in non-frails 32.8% CI in pre-frails 55.8 % CI in frails 10% frail 46% pre-frail 44% non-frail in women Global cognition and cognitive domains associated with frailty
Kulmala et al. (2014)	Kuopio, Finland	N=654 Age: 82	Fried et al. criteria	MMSE	26% CI 14% frail 48% pre-frail 38% non-frail Association between cognitive impairment and frailty. Risk for cognitive impairment and dementia
Langlois et al. (2012)	Quebec, Canada	N=83 Age: 74.26 74.4% female	Fried et al criteria, Modified Physical Performance Test and Edmonton	MMSE, WAIS-III, Trail Making Test and Rey Auditory Verbal Learning Test	Mean MMSE non-frail = 28.06 (±1.46) Mean MMSE frail = 28.24 (±1.48) 47% frail 53% non-frail Differences in executives function and processing speed between the two groups.
Macuco et al. (2012)	São Paulo, Brazil	N=384 Age: 72.3 67.2% female	Fried et al. criteria	MMSE	21.2% CI 8% frail 54.2% pre-frail 37.8% non-frail Poor performance on cognitive domains in frail elderly
Moreira, Lourenço (2013)	Rio de Janeiro, Brazil	N=847 Age: 76.3 66.9% female	Fried et al. criteria	MMSE	Mean MMSE = 25.47 (±3.37) 9.1% frail 47.3% pre-frail 43.6% non-frail Frail elderly had worse cognitive performance
Neri et al. (2013)	Seven cities, Brazil	N=3478 Age: 72.9 67.7% female	Fried et al. criteria	MMSE	24.8% CI 9.1% frail 51.8% pre-frail 39.1% non-frail. Association between frailty and cognition
Sánchez-García et al. (2014)	Mexico City, Mexico	N=1933 Age: 70.1 58% female	Fried & Walston criteria	MMSE	17.4% CI 15.7% frail 33.3% pre-frail 51% non-frail Cognitive impairment associated with pre-frailty
Santos et al. (2013)	Belem, Ermelino Matarazzo, Brazil	N=878 Age: 72.1 67.7% female	Fried et al. criteria	MMSE	Mean MMSE = 24.97\ 8% frail 50% pre-frail 42% non-frail Frail elderly had worse cognitive performance
Yassuda et al. (2012)	Ermelino Matarazzo, Brazil	N=384 Age: 72.3 67.2% female	Fried et al. criteria	Brief Cognitive Screening Battery and MMSE	16.6% CI 7% frail 54.2% pre-frail 38.8% non-frail Association between cognition and frailty

Study	Place	Demographics	Frailty measurement	Cognition measurement	Principal findings
Alencar et al. (2013)	Belo Horizonte, Brazil	N=207 Age:78.5 76.8% female	Fried et al. criteria	MMSE and CDR	6.4% CI in non-frails 25% CI in pre-frails 58.3% CI in frails 23.2% frail 54.1% pre-frail 22.7% non-frail Association between frailty and MMSE
Auyeung et al. (2011)	Hong Kong, China	N=2737 Age: 71.6 73.1% female	Five components*	MMSE	Mean MMSE in men = 27.4(±2.25) Mean MMSE in women = 25.8(±2.80) Frailty components can predict cognitive impairment.
Boyle et al. (2010)	Chicago, USA	N=750 Age: 79 76.4% female	Four components**	MMSE + twenty tests	Mean MMSE = 28.4 (±1.7) Frailty associated with decline in five cognitive domains (episodic memory, semantic memory, working memory, perception speed, and visuospatial abilities).
Cano et al. (2012)	Five states, USA	N=1815 Age:73.3 62.4% female	Fried et al. criteria	MMSE	CI in 8.8% of living group CI in 10.% of deceased group Association between cognitive impairment and frailty
Gray et al. (2013)	Seattle, USA	N=2619 Age:76.8 60% female	Fried et al. criteria	Ten tests	19.8% dementia incidence 8.1% frail 52.9% pre-frail 39% non-frail Interaction between cognition and frailty in elderly with dementia
Jacobs et al. (2011)	Jerusalem, Israel	N=840 Age: 85-90 53.3% female	Fried et al. criteria	MMSE	Mean MMSE = 25.6(±5.4) 19.5% frail 56% pre-frail 24.5% non-frail Association between cognitive impairment and frailty
Matusik et al. (2012)	Krakow, Poland	N=86 Age: 83.8 76.7% female	CSHA-CFS	MMSE	55.8% severe CI 75.6% frail Severe frailty and cognitive impairment can predict mortality
Raji et al. (2010)	Five states, USA	N=942 Age: 73.3 57.8% female	Fried & Walston criteria	MMSE	Mean MMSE of <21 group = 18.6(±2.4) Mean MMSE of ≥21 group= 26.1(±3.2) Worse cognition had association with risk of frailty Increased slowness in cognitive impairment
Rolfson et al. (2013)	Alberta, Canada	N=164 Age: 74 53% female	Edmonton and Fried et al.	MMSE, PCT, LCT	Mean MMSE = 26.7 (±4.32) Association between frailty and neurocognitive speed

[TFN04] MMSE: Mini-Mental State Examination; CI: cognitive impairment.

Relationship between cognition and frailty in elderly: A systematic review

Relação entre cognição e fragilidade em idosos: uma revisão sistemática