Skip to main content
SpringerLink
Log in

Cognitive aspects of frailty: Mechanisms behind the link between frailty and cognitive impairment

  • Published:
The journal of nutrition, health & aging

Abstract

Whereas physical impairment is the main hallmark of frailty, evidence suggests that other dimensions, such as psychological, cognitive and social factors also contribute to this multidimensional condition. Cognition is now considered a relevant domain of frailty. Cognitive and physical frailty interact: cognitive problems and dementia are more prevalent in physically frail individuals, and those with cognitive impairment are more prone to become frail. Disentangling the relationship between cognition and frailty may lead to new intervention strategies for the prevention and treatment of both conditions. Both frailty and cognitive decline share common potential mechanisms. This review examines the relationship between frailty and cognitive decline and explores the role of vascular changes, hormones, vitamin D, inflammation, insulin resistance, and nutrition in the development of physical frailty and cognitive problems, as potential underlying mechanisms behind this link. Dual tasking studies may be a useful way to explore and understand the relation between cognitive and physical frailty. Further studies are needed to elucidate this complex relation to improve the outcomes of frailty.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Christensen K, Doblhammer G, Rau R, Vaupel JW. Ageing populations: the challenges ahead. Lancet 2009;374:1196–208

    Article  PubMed Central  PubMed  Google Scholar 

  2. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013;381:752–62

    Article  PubMed  Google Scholar 

  3. Berrut G, Andrieu S, Araujo de Carvalho I, Baeyens JP, Bergman H, et al. Promoting Access to Innovation for Frail Old Persons. IAGG (International Association of Gerontology and Geriatrics), WHO (World Health Organization) and SFGG (Societe Francaise de Geriatrie et de Gerontologie) Workshop — Athens January 20-21, 2012 Tool (GFST). The journal of nutrition, health & aging 2013;17:688–93

    Article  CAS  Google Scholar 

  4. Sternberg SA, Wershof Schwartz A, Karunananthan S, Bergman H, Mark Clarfield A. The identification of frailty: a systematic literature review. Journal of the American Geriatrics Society 2011;59:2129–38

    Article  PubMed  Google Scholar 

  5. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, et al. Frailty in older adults: evidence for a phenotype. The journals of gerontology. Series A, Biological sciences and medical sciences 2001;56:M146–56

    Article  Google Scholar 

  6. Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, et al. Phenotype of frailty: characterization in the women’s health and aging studies. The journals of gerontology. Series A, Biological sciences and medical sciences 2006;61:262–6

    Article  PubMed  Google Scholar 

  7. Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. Journal of the American Geriatrics Society 2012;60:1487–92

    Article  PubMed  Google Scholar 

  8. Ahmed N, Mandel R, Fain MJ. Frailty: an emerging geriatric syndrome. Am J Med 2007;120:748–53

    Article  PubMed  Google Scholar 

  9. Woods NF, LaCroix AZ, Gray SL, Aragaki A, Cochrane BB, et al. Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. Journal of the American Geriatrics Society 2005;53:1321–30

    Article  PubMed  Google Scholar 

  10. Rockwood K, Bergman H. (2012) FRAILTY: A Report from the 3(rd) Joint Workshop of IAGG/WHO/SFGG, Athens, January (2012) Canadian geriatrics journal: CGJ 2012;15:31–6

    PubMed Central  PubMed  Google Scholar 

  11. Rodriguez-Manas L, Feart C, Mann G, Vina J, Chatterji S, et al. Searching for an operational definition of frailty: a Delphi method based consensus statement: the frailty operative definition-consensus conference project. The journals of gerontology. Series A, Biological sciences and medical sciences 2013;68:62–7

    Article  PubMed Central  PubMed  Google Scholar 

  12. Ferrucci L, Guralnik JM, Studenski S, Fried LP, Cutler GB, Walston JD. Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. Journal of the American Geriatrics Society 2004;52:625–34

    Article  PubMed  Google Scholar 

  13. Chin APMJ, Dekker JM, Feskens EJ, Schouten EG, Kromhout D. How to select a frail elderly population? A comparison of three working definitions. J Clin Epidemiol 1999;52:1015–21

    Article  Google Scholar 

  14. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. The journals of gerontology. Series A, Biological sciences and medical sciences 2004;59:255–63

    Article  PubMed  Google Scholar 

  15. Cruz-Jentoft AJMJ. Sarcopenia: A useful paradigm for physical frailty. Eur Geriatr Med. 2013;4(2):102–5.

    Article  Google Scholar 

  16. Ensrud KE, Ewing SK, Taylor BC, Fink HA, Cawthon PM, et al. Comparison of 2 frailty indexes for prediction of falls, disability, fractures, and death in older women. Archives of internal medicine 2008;168:382–9

    Article  PubMed  Google Scholar 

  17. Rockwood K, Andrew M, Mitnitski A. A comparison of two approaches to measuring frailty in elderly people. The journals of gerontology. Series A, Biological sciences and medical sciences 2007;62:738–43

    Article  PubMed  Google Scholar 

  18. Avila-Funes JA, Amieva H, Barberger-Gateau P, Le Goff M, Raoux N, et al. Cognitive impairment improves the predictive validity of the phenotype of frailty for adverse health outcomes: the three-city study. Journal of the American Geriatrics Society 2009;57:453–61

    Article  PubMed  Google Scholar 

  19. Rothman MD, Leo-Summers L, Gill TM. Prognostic significance of potential frailty criteria. Journal of the American Geriatrics Society 2008;56:2211–116

    Article  PubMed Central  PubMed  Google Scholar 

  20. Panza F, D’Introno A, Colacicco AM, Capurso C, Parigi AD, et al. Cognitive frailty: Predementia syndrome and vascular risk factors. Neurobiology of aging 2006;27:933–40

    Article  CAS  PubMed  Google Scholar 

  21. Kelaiditi E, Cesari M, Canevelli M, van Kan GA, Ousset PJ, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. The journal of nutrition, health & aging 2013;17:726–34

    Article  CAS  Google Scholar 

  22. Woods AJ, Cohen RA, Pahor M. Cognitive frailty: frontiers and challenges. The journal of nutrition, health & aging 2013;17:741–3

    Article  CAS  Google Scholar 

  23. Sourial N, Wolfson C, Bergman H, Zhu B, Karunananthan S, et al. A correspondence analysis revealed frailty deficits aggregate and are multidimensional. J Clin Epidemiol 2010;63:647–54

    Article  PubMed Central  PubMed  Google Scholar 

  24. Langlois F, Vu TT, Kergoat MJ, Chasse K, Dupuis G, Bherer L. The multiple dimensions of frailty: physical capacity, cognition, and quality of life. International psychogeriatrics / IPA 2012;24:1429–36

    Article  PubMed  Google Scholar 

  25. Macuco CR, Batistoni SS, Lopes A, Cachioni M, da Silva Falcao DV, et al. Mini-Mental State Examination performance in frail, pre-frail, and non-frail community dwelling older adults in Ermelino Matarazzo, Sao Paulo, Brazil. International psychogeriatrics / IPA 2012;24:1725–31

    Article  PubMed  Google Scholar 

  26. Jurschik P, Nunin C, Botigue T, Escobar MA, Lavedan A, Viladrosa M. Prevalence of frailty and factors associated with frailty in the elderly population of Lleida, Spain: the FRALLE survey. Arch Gerontol Geriatr 2012;55:625–31

    Article  PubMed  Google Scholar 

  27. Armstrong JJ, Stolee P, Hirdes JP, Poss JW. Examining three frailty conceptualizations in their ability to predict negative outcomes for home-care clients. Age and ageing 2010;39:755–8

    Article  PubMed  Google Scholar 

  28. Jacobs JM, Cohen A, Ein-Mor E, Maaravi Y, Stessman J. Frailty, cognitive impairment and mortality among the oldest old. The journal of nutrition, health & aging 2011;15:678–82

    Article  CAS  Google Scholar 

  29. Buchman AS, Boyle PA, Wilson RS, Tang Y, Bennett DA. Frailty is associated with incident Alzheimer’s disease and cognitive decline in the elderly. Psychosom Med 2007;69:483–9

    Article  PubMed  Google Scholar 

  30. Boyle PA, Buchman AS, Wilson RS, Leurgans SE, Bennett DA. Physical frailty is associated with incident mild cognitive impairment in community-based older persons. J Am Geriatr Soc 2010;58:248–55

    Article  PubMed Central  PubMed  Google Scholar 

  31. Avila-Funes JA, Carcaillon L, Helmer C, Carriere I, Ritchie K, et al. Is frailty a prodromal stage of vascular dementia? Results from the Three-City Study. Journal of the American Geriatrics Society 2012;60:1708–12

    Article  PubMed  Google Scholar 

  32. De Vriendt P, Gorus E, Cornelis E, Bautmans I, Petrovic M, Mets T. The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment. The journal of nutrition, health & aging 2013;17:64–71

    Article  Google Scholar 

  33. Gill TM, Gahbauer EA, Han L, Allore HG. Trajectories of disability in the last year of life. The New England journal of medicine 2010;362:1173–80

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  34. Lunney JR, Lynn J, Foley DJ, Lipson S, Guralnik JM. Patterns of functional decline at the end of life. JAMA: the journal of the American Medical Association 2003;289:2387–92

    Article  Google Scholar 

  35. Robertson DA, Savva GM, Kenny RA. Frailty and cognitive impairment-A review of the evidence and causal mechanisms. Ageing research reviews 2013;12:840–51

    Article  PubMed  Google Scholar 

  36. Walston J, Hadley EC, Ferrucci L, Guralnik JM, Newman AB, et al. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. Journal of the American Geriatrics Society 2006;54:991–1001

    Article  PubMed  Google Scholar 

  37. Jeffery CA, Shum DW, Hubbard RE. Emerging drug therapies for frailty. Maturitas 2013;74:21–5

    Article  CAS  PubMed  Google Scholar 

  38. de la Torre JC. The vascular hypothesis of Alzheimer’s disease: bench to bedside and beyond. Neurodegener Dis 2010;7:116–21

    Article  PubMed  Google Scholar 

  39. Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the american heart association/american stroke association. Stroke; a journal of cerebral circulation 2011;42:2672–713

    Article  PubMed Central  PubMed  Google Scholar 

  40. Strandberg TE, Pitkala KH, Tilvis RS, O’Neill D, Erkinjuntti TJ. Geriatric syndromes—vascular disorders? Annals of Medicine 2013;45:265–73

    Article  PubMed  Google Scholar 

  41. Dede DS, Yavuz B, Yavuz BB, Cankurtaran M, Halil M, et al. Assessment of endothelial function in Alzheimer’s disease: is Alzheimer’s disease a vascular disease? Journal of the American Geriatrics Society 2007;55:1613–7

    Article  PubMed  Google Scholar 

  42. Bouillon K, Batty GD, Hamer M, Sabia S, Shipley MJ, et al. Cardiovascular disease risk scores in identifying future frailty: the Whitehall II prospective cohort study. Heart 2013;99:737–42

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  43. Strandberg TE, Sirola J, Pitkala KH, Tilvis RS, Strandberg AY, Stenholm S. Association of midlife obesity and cardiovascular risk with old age frailty: a 26-year follow-up of initially healthy men. International journal of obesity 2012;36:1153–7

    Article  CAS  PubMed  Google Scholar 

  44. Newman AB, Gottdiener JS, McBurnie MA, Hirsch CH, Kop WJ, et al. Associations of subclinical cardiovascular disease with frailty. The journals of gerontology. Series A, Biological sciences and medical sciences 2001;56:M158–66

    Article  Google Scholar 

  45. Morley JE, Malmstrom TK. Frailty, sarcopenia, and hormones. Endocrinology and metabolism clinics of North America 2013;42:391–405

    Article  PubMed  Google Scholar 

  46. Travison TG, Nguyen AH, Naganathan V, Stanaway FF, Blyth FM, et al. Changes in reproductive hormone concentrations predict the prevalence and progression of the frailty syndrome in older men: the concord health and ageing in men project. The Journal of clinical endocrinology and metabolism 2011;96:2464–74

    Article  CAS  PubMed  Google Scholar 

  47. Varadhan R, Walston J, Cappola AR, Carlson MC, Wand GS, Fried LP. Higher levels and blunted diurnal variation of cortisol in frail older women. The journals of gerontology. Series A, Biological sciences and medical sciences 2008;63:190–5

    Article  PubMed  Google Scholar 

  48. Morley JE, Baumgartner RN, Roubenoff R, Mayer J, Nair KS. Sarcopenia. J Lab Clin Med 2001;137:231–43

    Article  CAS  PubMed  Google Scholar 

  49. Maggio M, Dall’Aglio E, Lauretani F, Cattabiani C, Ceresini G, et al. The hormonal pathway to cognitive impairment in older men. The journal of nutrition, health & aging 2012;16:40–54

    Article  CAS  Google Scholar 

  50. Muller M, Grobbee DE, Thijssen JH, van den Beld AW, van der Schouw YT. Sex hormones and male health: effects on components of the frailty syndrome. Trends Endocrinol Metab 2003;14:289–96

    Article  CAS  PubMed  Google Scholar 

  51. Mohr BA, Bhasin S, Kupelian V, Araujo AB, O’Donnell AB, McKinlay JB. Testosterone, sex hormone-binding globulin, and frailty in older men. Journal of the American Geriatrics Society 2007;55:548–55

    Article  PubMed  Google Scholar 

  52. Leng SX, Cappola AR, Andersen RE, Blackman MR, Koenig K, et al. Serum levels of insulin-like growth factor-I (IGF-I) and dehydroepiandrosterone sulfate (DHEAS), and their relationships with serum interleukin-6, in the geriatric syndrome of frailty. Aging Clin Exp Res 2004;16:153–7

    Article  CAS  PubMed  Google Scholar 

  53. Gouras GK, Xu H, Gross RS, Greenfield JP, Hai B, et al. Testosterone reduces neuronal secretion of Alzheimer’s beta-amyloid peptides. Proc Natl Acad Sci U S A 2000;97:1202–5

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  54. Tenover JS. Androgen replacement therapy to reverse and/or prevent age-associated sarcopenia in men. Baillieres Clin Endocrinol Metab 1998;12:419–25

    Article  CAS  PubMed  Google Scholar 

  55. Nass R, Thorner MO. Impact of the GH-cortisol ratio on the age-dependent changes in body composition. Growth Horm IGF Res 2002;12:147–61

    Article  CAS  PubMed  Google Scholar 

  56. Nyberg F, Hallberg M. Growth hormone and cognitive function. Nat Rev Endocrinol 2013;9:357–65

    Article  CAS  PubMed  Google Scholar 

  57. Baker LD, Barsness SM, Borson S, Merriam GR, Friedman SD, et al. Effects of growth hormone-releasing hormone on cognitive function in adults with mild cognitive impairment and healthy older adults: results of a controlled trial. Arch Neurol 2012;69:1420–9

    Article  PubMed Central  PubMed  Google Scholar 

  58. Holanda CM, Guerra RO, Nobrega PV, Costa HF, Piuvezam MR, Maciel AC. Salivary cortisol and frailty syndrome in elderly residents of long-stay institutions: a cross-sectional study. Arch Gerontol Geriatr 2012;54:e146–51

    Article  Google Scholar 

  59. Lee BK, Glass TA, McAtee MJ, Wand GS, Bandeen-Roche K, et al. Associations of salivary cortisol with cognitive function in the Baltimore memory study. Arch Gen Psychiatry 2007;64:810–8

    Article  CAS  PubMed  Google Scholar 

  60. Serra-Prat M, Palomera E, Clave P, Puig-Domingo M. Effect of age and frailty on ghrelin and cholecystokinin responses to a meal test. The American journal of clinical nutrition 2009;89:1410–7

    Article  CAS  PubMed  Google Scholar 

  61. Kalyani RR, Varadhan R, Weiss CO, Fried LP, Cappola AR. Frailty status and altered dynamics of circulating energy metabolism hormones after oral glucose in older women. The journal of nutrition, health & aging 2012;16:679–86

    Article  CAS  Google Scholar 

  62. Theodoropoulou A, Metallinos IC, Psyrogiannis A, Vagenakis GA, Kyriazopoulou V. Ghrelin and leptin secretion in patients with moderate Alzheimer’s disease. The journal of nutrition, health & aging 2012;16:472–7

    Article  CAS  Google Scholar 

  63. Gahete MD, Cordoba-Chacon J, Kineman RD, Luque RM, Castano JP. Role of ghrelin system in neuroprotection and cognitive functions: implications in Alzheimer’s disease. Peptides 2011;32:2225–8

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  64. Uusi-Rasi K, Karkkainen MU, Lamberg-Allardt CJ. Calcium intake in health maintenance — a systematic review. Food Nutr Res 2013;57

    Google Scholar 

  65. Ensrud KE, Blackwell TL, Cauley JA, Cummings SR, Barrett-Connor E, et al. Circulating 25-hydroxyvitamin D levels and frailty in older men: the osteoporotic fractures in men study. Journal of the American Geriatrics Society 2011;59:101–6

    Article  PubMed Central  PubMed  Google Scholar 

  66. Shardell M, Hicks GE, Miller RR, Kritchevsky S, Andersen D, et al. Association of low vitamin D levels with the frailty syndrome in men and women. The journals of gerontology. Series A, Biological sciences and medical sciences 2009;64:69–75

    Article  PubMed  Google Scholar 

  67. Mason C, Xiao L, Imayama I, Duggan CR, Foster-Schubert KE, et al. Influence of diet, exercise, and serum vitamin d on sarcopenia in postmenopausal women. Med Sci Sports Exerc 2013;45:607–14

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  68. Puts MT, Visser M, Twisk JW, Deeg DJ, Lips P. Endocrine and inflammatory markers as predictors of frailty. Clin Endocrinol (Oxf) 2005;63:403–11

    Article  CAS  Google Scholar 

  69. Wong YY, McCaul KA, Yeap BB, Hankey GJ, Flicker L. Low vitamin d status is an independent predictor of increased frailty and all-cause mortality in older men: the health in men study. The Journal of clinical endocrinology and metabolism 2013;98:3821–8

    Article  CAS  PubMed  Google Scholar 

  70. van der Schaft J, Koek HL, Dijkstra E, Verhaar HJ, van der Schouw YT, Emmelot-Vonk MH. The association between vitamin D and cognition: A systematic review. Ageing Res Rev, 2013

    Google Scholar 

  71. Brouwer-Brolsma EM, van de Rest O, Tieland M, van der Zwaluw NL, Steegenga WT, et al. Serum 25-Hydroxyvitamin D Is Associated With Cognitive Executive Function in Dutch Prefrail and Frail Elderly: A Cross-Sectional Study Exploring the Associations of 25-Hydroxyvitamin D With Glucose Metabolism, Cognitive Performance and Depression. Journal of the American Medical Directors Association, 2013

    Google Scholar 

  72. Aktas O, Ullrich O, Infante-Duarte C, Nitsch R, Zipp F. Neuronal damage in brain inflammation. Arch Neurol 2007;64:185–9

    Article  PubMed  Google Scholar 

  73. Jefferson AL, Massaro JM, Wolf PA, Seshadri S, Au R, et al. Inflammatory biomarkers are associated with total brain volume: the Framingham Heart Study. Neurology 2007;68:1032–8

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  74. Gorelick PB. Role of inflammation in cognitive impairment: results of observational epidemiological studies and clinical trials. Annals of the New York Academy of Sciences 2010;1207:155–62

    Article  PubMed  Google Scholar 

  75. Baune BT, Ponath G, Golledge J, Varga G, Arolt V, et al. Association between IL-8 cytokine and cognitive performance in an elderly general population—the MEMOStudy. Neurobiology of aging 2008;29:937–44

    Article  CAS  PubMed  Google Scholar 

  76. Yaffe K, Lindquist K, Penninx BW, Simonsick EM, Pahor M, et al. Inflammatory markers and cognition in well-functioning African-American and white elders. Neurology 2003;61:76–80

    Article  CAS  PubMed  Google Scholar 

  77. Hubbard RE, Woodhouse KW. Frailty, inflammation and the elderly. Biogerontology 2010;11:635–41

    Article  PubMed  Google Scholar 

  78. Leng S, Chaves P, Koenig K, Walston J. Serum interleukin-6 and hemoglobin as physiological correlates in the geriatric syndrome of frailty: a pilot study. Journal of the American Geriatrics Society 2002;50:1268–71

    Article  PubMed  Google Scholar 

  79. Michaud M, Balardy L, Moulis G, Gaudin C, Peyrot C, et al. Proinflammatory Cytokines, Aging, and Age-Related Diseases. Journal of the American Medical Directors Association, 2013

    Google Scholar 

  80. Collerton J, Martin-Ruiz C, Davies K, Hilkens CM, Isaacs J, et al. Frailty and the role of inflammation, immunosenescence and cellular ageing in the very old: crosssectional findings from the Newcastle 85+ Study. Mechanisms of ageing and development 2012;133:456–66

    Article  CAS  PubMed  Google Scholar 

  81. Mulero J, Zafrilla P, Martinez-Cacha A. Oxidative stress, frailty and cognitive decline. The journal of nutrition, health & aging 2011;15:756–60

    Article  CAS  Google Scholar 

  82. de la Monte SM, Wands JR. Alzheimer’s disease is type 3 diabetes-evidence reviewed. J Diabetes Sci Technol 2008;2:1101–13

    Article  PubMed Central  PubMed  Google Scholar 

  83. Neumann KF, Rojo L, Navarrete LP, Farias G, Reyes P, Maccioni RB. Insulin resistance and Alzheimer’s disease: molecular links & clinical implications. Curr Alzheimer Res 2008;5:438–47

    Article  CAS  PubMed  Google Scholar 

  84. Zhong Y, Miao Y, Jia WP, Yan H, Wang BY, Jin J. Hyperinsulinemia, insulin resistance and cognitive decline in older cohort. Biomed Environ Sci 2012;25:8–14

    PubMed  Google Scholar 

  85. Barzilay JI, Blaum C, Moore T, Xue QL, Hirsch CH, et al. Insulin resistance and inflammation as precursors of frailty: the Cardiovascular Health Study. Archives of internal medicine 2007;167:635–41

    Article  PubMed  Google Scholar 

  86. Gillette Guyonnet S, Abellan Van Kan G, Andrieu S, Barberger Gateau P, Berr C, et al. IANA task force on nutrition and cognitive decline with aging. The journal of nutrition, health & aging 2007;11:132–52

    CAS  Google Scholar 

  87. Gillette-Guyonnet S, Secher M, Vellas B. Nutrition and neurodegeneration: epidemiological evidence and challenges for future research. British journal of clinical pharmacology 2013;75:738–55

    PubMed Central  CAS  PubMed  Google Scholar 

  88. Perez L, Heim L, Sherzai A, Jaceldo-Siegl K, Sherzai A. Nutrition and vascular dementia. The journal of nutrition, health & aging 2012;16:319–24

    Article  CAS  Google Scholar 

  89. Lee KS, Cheong HK, Kim EA, Kim KR, Oh BH, Hong CH. Nutritional risk and cognitive impairment in the elderly. Arch Gerontol Geriatr 2009;48:95–9

    Article  PubMed  Google Scholar 

  90. Torres SJ, Lautenschlager NT, Wattanapenpaiboon N, Greenop KR, Beer C, et al. Dietary patterns are associated with cognition among older people with mild cognitive impairment. Nutrients 2012;4:1542–51

    Article  PubMed Central  PubMed  Google Scholar 

  91. Smit E, Winters-Stone KM, Loprinzi PD, Tang AM, Crespo CJ. Lower nutritional status and higher food insufficiency in frail older US adults. The British journal of nutrition 2013;110:172–8

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  92. Beasley JM, LaCroix AZ, Neuhouser ML, Huang Y, Tinker L, et al. Protein intake and incident frailty in the Women’s Health Initiative observational study. Journal of the American Geriatrics Society 2010;58:1063–71

    Article  PubMed Central  PubMed  Google Scholar 

  93. Bartali B, Frongillo EA, Bandinelli S, Lauretani F, Semba RD, et al. Low nutrient intake is an essential component of frailty in older persons. The journals of gerontology. Series A, Biological sciences and medical sciences 2006;61:589–93

    Article  PubMed Central  PubMed  Google Scholar 

  94. Bollwein J, Volkert D, Diekmann R, Kaiser MJ, Uter W, et al. Nutritional status according to the mini nutritional assessment (MNA(R)) and frailty in community dwelling older persons: a close relationship. The journal of nutrition, health & aging 2013;17:351–6

    Article  CAS  Google Scholar 

  95. Verhaeghen P, Steitz DW, Sliwinski MJ, Cerella J. Aging and dual-task performance: a meta-analysis. Psychol Aging 2003;18:443–60

    Article  PubMed  Google Scholar 

  96. Al-Yahya E, Dawes H, Smith L, Dennis A, Howells K, Cockburn J. Cognitive motor interference while walking: a systematic review and meta-analysis. Neuroscience and biobehavioral reviews 2011;35:715–28

    Article  PubMed  Google Scholar 

  97. Kang HG, Costa MD, Priplata AA, Starobinets OV, Goldberger AL, et al. Frailty and the degradation of complex balance dynamics during a dual-task protocol. The journals of gerontology. Series A, Biological sciences and medical sciences 2009;64:1304–11

    Article  PubMed  Google Scholar 

  98. Schwenk M, Howe C, Saleh A, Mohler J, Grewal G, et al. Frailty and Technology: A Systematic Review of Gait Analysis in Those with Frailty. Gerontology, 2013

    Google Scholar 

  99. Gillain S, Warzee E, Lekeu F, Wojtasik V, Maquet D, et al. The value of instrumental gait analysis in elderly healthy, MCI or Alzheimer’s disease subjects and a comparison with other clinical tests used in single and dual-task conditions. Annals of physical and rehabilitation medicine 2009;52:453–74

    Article  CAS  PubMed  Google Scholar 

  100. Peek MK, Howrey BT, Ternent RS, Ray LA, Ottenbacher KJ. Social support, stressors, and frailty among older Mexican American adults. The journals of gerontology. Series B, Psychological sciences and social sciences 2012;67:755–64

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University, Ankara, Turkey

    M. Halil, Muhammet Cemal Kizilarslanoglu, M. Emin Kuyumcu & Y. Yesil

  2. Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Madrid, Spain

    A. J. Cruz Jentoft

Authors
  1. M. Halil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Muhammet Cemal Kizilarslanoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Emin Kuyumcu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y. Yesil
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A. J. Cruz Jentoft
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Muhammet Cemal Kizilarslanoglu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Halil, M., Cemal Kizilarslanoglu, M., Emin Kuyumcu, M. et al. Cognitive aspects of frailty: Mechanisms behind the link between frailty and cognitive impairment. J Nutr Health Aging 19, 276–283 (2015). https://doi.org/10.1007/s12603-014-0535-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-014-0535-z

Key words

Search

Navigation