ArticleThe journals of gerontology. Series A, Biological sciences and medical sciences2019
Hierarchical Development of Frailty and Cognitive Impairment: Clues Into Etiological Pathways.
Article in The journals of gerontology. Series A, Biological sciences and medical sciences, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prevalence and Associated Risk Factors of Cognitive Frailty: A Systematic Review and Meta-Analysis.Frontiers in aging neuroscience · 2021Pooled it
- Impact of multidomain lifestyle intervention on dynamics of cognitive frailty: post hoc analysis of the FINGER trial.The journals of gerontology. Series A, Biological sciences and medical sciences · 2026Trial
- Cognitive trajectories and mortality risk in older adults: a 9-year follow-up study.GeroScience · 2026Article
- Medicare costs and home time loss among fee-for-service beneficiaries by frailty and dementia status.The Journal of frailty & aging · 2026Article
- Article
- Cognitive frailty: a useful concept or a source of confusion? Insights from a survey of European geriatricians.BMC geriatrics · 2025Article
- Association of multimorbidity patterns and order of physical frailty and cognitive impairment occurrence: a prospective cohort study.Age and ageing · 2025Article
- Association of Longitudinal Trajectories of Physical Frailty With Dementia Status in Older Adults: A National Cohort Study.International journal of geriatric psychiatry · 2025Article
- Factors affecting cognitive frailty improvement and progression in Taiwanese older adults.BMC geriatrics · 2024Article
- Review
- Hierarchical Development of Physical Frailty and Cognitive Impairment and Their Association With Incident Cardiovascular Disease.JACC. Advances · 2023Article
- Order of Onset of Physical Frailty and Cognitive Impairment and Risk of Repeated Falls in Community-Dwelling Older Adults.Journal of the American Medical Directors Association · 2023Observational
- Predictors of incident reversible and potentially reversible cognitive frailty among Taiwanese older adults.BMC geriatrics · 2023Article
- The transitions and predictors of cognitive frailty with multi-state Markov model: a cohort study.BMC geriatrics · 2022Article
- The Flexibility of Physio-Cognitive Decline Syndrome: A Longitudinal Cohort Study.Frontiers in public health · 2022Article
- Patterns of the physical, cognitive, and mental health status of older individuals in a real-life primary care setting and differences in coping styles.Frontiers in medicine · 2022Article
- Association between cognitive frailty and falls among older community dwellers in China: A Chinese longitudinal healthy longevity survey-based study.Frontiers in aging neuroscience · 2022Article
- 10-year frailty trajectory is associated with Alzheimer's dementia after considering neuropathological burden.Aging medicine (Milton (N.S.W)) · 2021Article
- Frailty, With or Without Cognitive Impairment, Is a Strong Predictor of Recurrent Falls in a US Population-Representative Sample of Older Adults.The journals of gerontology. Series A, Biological sciences and medical sciences · 2021Article
- Cognitive impairment burden in older and younger adults across the kidney transplant care continuum.Clinical transplantation · 2021Article
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7 authors.
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Abstract
backgroundFrailty and cognitive impairment (CI) are associated and often coexist in older adults. Whether temporal patterns of occurrence reflect different etiologies remain unknown.
methodsParticipants from the National Health and Aging Trends Study were assessed annually (2011-2016) for frailty (Fried's criteria) and CI (bottom quintile of clock drawing test or immediate and delayed recall; proxy-report of dementia diagnosis or AD8 ≥ 2). We used the Fine & Gray model to identify correlates of frailty onset before CI, CI onset before frailty, and frailty-CI co-occurrence, accounting for death as a competing risk.
resultsOf 3,848 free of frailty, CI, and dementia at baseline, 2,183 (61.2%) developed neither frailty nor CI during the 5-year follow-up; 343 (8.3%) developed frailty first; 1,014 (24.4%) developed CI first; and 308 (6.0%) developed frailty-CI co-occurrence. Incident dementia, as a marker of underlying neuropathologies, was associated with greater likelihood of CI onset first (subdistribution hazard ratios [SHR] = 2.60, 95% confidence interval [ci] 2.09 to 3.24), and frailty-CI co-occurrence (SHR = 8.77, 95% ci 5.79 to 13.28), but lower likelihood of frailty onset first (SHR = 0.38, 95% ci 0.21 to 0.68). Number of comorbidities was only associated with frailty occurrence first (1 comorbidity: SHR = 2.51, 95% ci 1.15 to 5.47; 4+ comorbidities: SHR = 6.48, 95% ci 2.78 to 15.48).
conclusionsDifferent patterns of frailty and CI occurrence exist, and dementia-related pathologies and comorbidities may be important correlates of order of emergence, potentially reflecting different etiologies. Future investigation into relationships between these patterns and dementia subtypes and related pathologies is needed to elucidate etiologic pathways and to provide new targets for prevention, intervention, and risk screening.
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