ArticleThe American journal of medicine2021
Cognitive Function, Sarcopenia, and Inflammation Are Strongly Associated with Frailty: A Framingham Cohort Study.
Article in The American journal of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 3 of them syntheses that pooled it.
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Who cites it
23 citing papers in PubMed, 3 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Level of IL-6, TNF, and IL-1β and age-related diseases: a systematic review and meta-analysis.Frontiers in immunology · 2024Pooled it
- Predictors of cognitive decline in older individuals without dementia: An updated meta-analysis.Annals of clinical and translational neurology · 2023Pooled it
- The association between metabolic syndrome and presence of frailty: a systematic review and meta-analysis.European geriatric medicine · 2022Pooled it
- Rifaximin Improves Frailty in Patients with Decompensated Cirrhosis: A Randomized Trial.Digestive diseases and sciences · 2026Trial
- Trial
- Cross-Sectional Associations of Cognitive Function, Frailty, Depressive Symptoms, and Self-Care Dependence in Residents of a Long-Term Care Institution.Healthcare (Basel, Switzerland) · 2026Article
- Sarcopenia in cognitive disorders: Toward a shared pathophysiological framework.Osteoporosis and sarcopenia · 2026Review
- Serum creatinine to cystatin C ratio and risk of incident digestive diseases in middle-aged and older adults: a prospective national cohort study.Scientific reports · 2026Article
- Burden of malnutrition and sarcopenia in patients with cirrhosis: pathophysiology, assessment, and management.Clinical and molecular hepatology · 2026Review
- The independent association of social isolation and loneliness with cognitive frailty in Chinese older adults: a cross-sectional study.BMC public health · 2025Article
- Unraveling the Metabolic Pathways Between Metabolic-Associated Fatty Liver Disease (MAFLD) and Sarcopenia.International journal of molecular sciences · 2025Review
- Exploring the Relationship Between Gut Microbiota and Sarcopenia Based on Gut-Muscle Axis.Food science & nutrition · 2024Review
- Association of platelet-to-HDL cholesterol ratio with frailty and all-cause mortality.Lipids in health and disease · 2024Article
- Development and validation of an explainable machine learning model for predicting multidimensional frailty in hospitalized patients with cirrhosis.Briefings in bioinformatics · 2024Article
- Creatinine-to-cystatin C ratio and frailty in older adults: a longitudinal cohort study.BMC geriatrics · 2024Article
- Effects of cigarette smoking and secondhand smoke exposure on physical frailty development among community-dwelling older adults in Japan: Evidence from a 10-year population-based cohort study.Geriatrics & gerontology international · 2024Article
- Association between frailty and hepatic fibrosis in NAFLD among middle-aged and older adults: results from NHANES 2017-2020.Frontiers in public health · 2024Article
- Assessment of the Risk of Malnutrition or Frailty Among Patients Undergoing Liver Transplantation: A Hospital-Based Prospective Study.International journal of general medicine · 2024Article
- Portal Hypertension in Malnutrition and Sarcopenia in Decompensated Cirrhosis-Pathogenesis, Implications and Therapeutic Opportunities.Nutrients · 2023Review
- Longitudinal relationships between grip strength, subjective memory complaints and cognitive function among middle-aged and older adults in China.Aging clinical and experimental research · 2023Article
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundFrailty is an important contributor to morbidity and mortality in chronic liver disease. Understanding the contributors to frailty has the potential to identify individuals at risk for frailty and may potentially provide targets for frailty-modifying interventions. We evaluated the relationship among cognitive function, inflammation, and sarcopenia and frailty.
methodsUsing cohorts from the Framingham Heart Study (2011-2014), we evaluated for factors associated with frailty. Exposures included cognitive tests (combined Trails A/B test, Animal Naming Test, and combined Digit Span Forward/Backward test), inflammation (interleukin-6 and tumor necrosis factor receptor II), and sarcopenia (creatinine-to-cystatin C ratio). We performed linear and logistic regression to identify the relationship between these exposures and the Liver Frailty Index (LFI).
resultsThe study population (N = 1208) had a median age of 70 years, was 56% female, and 48.5% had evidence of liver disease. The combined Trails A/B test (β 0.05, P < .001), creatinine-to-cystatin C (β -0.17, P = .006), and both inflammatory markers, interleukin-6 levels (β 0.16, P = .002) and tumor necrosis factor receptor II (β 0.21, P = .04), were independently associated with the LFI. Using an LFI cutoff of ≥4.5 to define frailty, Trails A/B (odds ratio [OR] 1.21, 95% confidence interval [CI] 1.07-1.37), Animal Naming Test (OR 0.64, 95% CI 0.42-0.97), sarcopenia (OR 0.10, 95% CI 0.01-0.73), and interleukin-6 (OR 4.99, 95% CI 1.03-15.53) were all associated with frailty. Although liver disease did not modify the relationship between the LFI and the Trails A/B test, interleukin-6 was significantly associated with the LFI only in the presence of liver disease.
conclusionsCognitive performance, inflammation, and sarcopenia, each highly prevalent in cirrhosis, are associated with the LFI in this population-based study of persons without cirrhosis. Further research is warranted for interventions aiming to prevent frailty by tailoring their approach to the patient's underlying risk factors.
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