http://orcid.org/0000-0002-2479-1076
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Abstract
Objectives: Cognitive frailty is a state at the lower end of the continuum of cognitive resilience in which one is at elevated risk for cognitive impairment and dementia. Metrics of a newly developed Cognitive Frailty Index (CFI) were examined for their association with objective functional limitations.
Methods: We used baseline data from 607 participants from the Baltimore Experience Corps Trial with measures on the CFI, a computerized Stroop test, and Short Physical Performance Battery (SPPB) score ≤9. Multivariable log-binomial regression models were used to evaluate the associations of CFI metrics (mean reaction time (RT) for total, first-half and second-half trials per condition) with the SPPB. Latent growth models were used to create additional CFI metrics of initial level (intercept) and change (slope) in RT across accurate trials by easy (Color-X) and difficult (Color-Word) conditions. Models were adjusted for race, sex, age, income, major morbidities, depressive symptoms, self-reported health, and Stroop interference (for Color-Word condition only).
Results: All CFI RT metrics were associated with SPPB <9, yet latent growth model approaches were most informative. Initial levels of performance on easy (Risk Ratio, [RR] = 1.24; 95% Confidence Interval, [CI]: 1.03, 1.49) and difficult conditions (RR = 1.22; 95% CI: 1.05, 1.41), not rates of learning (slope) (RR = 1.08, 95% CI: 0.81, 1.45 and RR = 1.11, 95% CI: 0.96, 1.27 respectively), were associated with worse physical functioning.
Conclusions: The association between the CFI and physical functioning demonstrates the interplay of cognitive frailty and worse objective mobility within a sociodemographic at-risk sample.
Acknowledgements
Members of The Baltimore Experience Corps Trial cohort.
Dr. Armstrong had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Author contributions are as follows. Study concept and design: Armstrong, Carlson. Acquisition of data: Armstrong, Andrews, Gross, Varma, Xue, Carlson. Analysis and interpretation of the data: Armstrong, Andrews, Gross, Varma, Xue, Carlson. Drafting the manuscript: Armstrong, Carlson. Critical revision of the manuscript for important intellectual content: Armstrong, Andrews, Gross, Varma, Xue, Carlson. Obtained funding: Carlson. Administrative, technical, and material support: Armstrong, Andrews, Gross, Varma, Xue, Carlson. Study supervision: Carlson.
Disclosure statement
None of the authors have a conflict of interest to declare.
Funding/support
Drs. Armstrong and Varma are supported by the Intramural Research Program, National Institute on Aging, NIH. Dr. Andrews was supported by the National Institute on Aging (T32 AG027668) and the National Institute of Mental Health (T32MH014592). Dr. Gross was supported by K01-AG050699 from the National Institute on Aging. This work was supported by funding from the National Institute on Aging (P01 AG027735-03).