Background:Very few studies have investigated the impact of cognitive frailty in clinical settings, especially in memory clinic populations. Objective:To examine the impact of cognitive frailty on activities of daily living (ADL), cognitive function, and conversion to dementia among memory clinic patients with mild cognitive impairment (MCI). Methods:The subjects of this retrospective study were 248 MCI patients (mean age, 76.3±5.4 years; females, 60.9%). All subjects completed a comprehensive geriatric assessment at baseline and at least one assessment during 3-year follow-up. Frailty was defined by generating a frailty index (FI), and MCI patients with frailty (FI≥0.25) were considered to represent cognitive frailty. As primary outcomes, the Barthel Index, Mini-Mental State Examination, and incident dementia were evaluated during follow-up. At baseline, patients were assessed for apolipoprotein E (APOE) phenotype. A linear mixed model, as well as a Cox proportional hazards regression model with adjustment for confounding variables, was performed. Results:Of these patients, 75 (30.2%) were classified as cognitive frail. APOE ɛ4 carriers accounted for 26.7% of those with cognitive frailty and 44.5% of those without (p = 0.008). Cognitive frail patients showed a faster ADL decline (estimate, –1.04; standard error, 0.38; p = 0.007) than patients without cognitive frailty. Cognitive frailty was not associated with cognitive decline and incident dementia. Conclusion:Our findings demonstrated cognitive frailty increases the risk of dependence but not cognitive outcomes. Cognitive frailty may have heterogeneous conditions, including APOE ɛ4-related pathologies, which may affect the cognitive trajectories of patients with MCI.

中文翻译：

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认知脆弱对轻度认知障碍患者的日常生活，认知功能和痴呆转化的影响。

背景：很少有研究调查认知脆弱在临床环境中的影响，尤其是在记忆诊所人群中。目的：探讨轻度认知障碍（MCI）的记忆临床患者的认知脆弱性对日常生活活动（ADL），认知功能和痴呆转化的影响。方法：该回顾性研究的受试者为248例MCI患者（平均年龄76.3±5.4岁；女性60.9％）。所有受试者均在基线完成了一项全面的老年医学评估，并在3年​​的随访期间至少完成了一项评估。脆弱是通过产生脆弱指数（FI）来定义的，并且MCI脆弱（FI≥0.25）的患者被认为代表认知脆弱。作为主要结果，在随访过程中评估了Barthel指数，小精神状态检查和痴呆事件。在基线时，评估患者的载脂蛋白E（APOE）表型。进行了线性混合模型，以及对混杂变量进行了调整的Cox比例风险回归模型。结果：在这些患者中，有75名（30.2％）被归类为认知脆弱。APOEɛ4携带者占认知脆弱者的26.7％，无认知能力携带者的44.5％（p = 0.008）。与没有认知能力弱的患者相比，认知能力弱的患者显示出ADL下降更快（估计值为–1.04；标准误为0.38； p = 0.007）。认知脆弱与认知能力下降和突发性痴呆无关。结论：我们的研究结果表明，认知脆弱会增加依赖的风险，但不会增加认知结果。认知弱点可能有多种情况，包括与APOE OE4相关的病理，