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Review
. 2020 Mar 9;11(2):405-418.
doi: 10.14336/AD.2019.0521. eCollection 2020 Apr.

Understanding the Physiological Links Between Physical Frailty and Cognitive Decline

Lina Ma  1   2 , Piu Chan  1   2   3   4
Affiliations
Review

Understanding the Physiological Links Between Physical Frailty and Cognitive Decline

Lina Ma et al. Aging Dis. .

Abstract

Declines in both physical and cognitive function are associated with increasing age. Understanding the physiological link between physical frailty and cognitive decline may allow us to develop interventions that prevent and treat both conditions. Although there is significant epidemiological evidence linking physical frailty to cognitive decline, a complete understanding of the underpinning biological basis of the two disorders remains fragmented. This narrative review discusses insights into the potential roles of chronic inflammation, impaired hypothalamic-pituitary axis stress response, imbalanced energy metabolism, mitochondrial dysfunction, oxidative stress, and neuroendocrine dysfunction linking physical frailty with cognitive decline. We highlight the importance of easier identification of strategic approaches delaying the progression and onset of physical frailty and cognitive decline as well as preventing disability in the older population.

Keywords: biology; cognitive decline; cognitive frailty; physical frailty.

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Conflict of interest statement

Competing and conflicts of interest None of the authors have any conflicts or competing interests in the article.

Figures

Figure 1.
Figure 1.
The model of cognitive frailty. Physical frailty and cognitive impairment have the same etiology, and might share the same mechanisms, which lead to adverse health outcomes. The decline in physical reserve and cognitive function contribute to frailty and cognitive impairment separately. Cognitive frailty is the combination of frailty and cognitive impairment in absence of dementia, which is further divided into reversible cognitive frailty (prefrailty and subjective cognitive decline) and potentially reversible cognitive frailty (physical frailty and mild cognitive impairment).Abbreviations: CF, cognitive frailty; SCD, subjective cognitive decline; MCI, mild cognitive impairment; AD, Alzheimer's disease.
Figure 2.
Figure 2.
Overview of the underlying mechanisms linking physical frailty to cognitive decline. Chronic inflammation, impaired HPA stress response, imbalanced energy metabolism, endocrine dysregulation, mitochondrial dysfunction, oxidative stress, genomic markers and metabolomic markers are major underlying mechanisms between physical frailty (muscle) and cognitive decline (brain).
See this image and copyright information in PMC

References

    1. Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013). Frailty in elderly people. Lancet, 381(9868):752-762. - PMC - PubMed
    1. Dent E, Dent E, Lien C, Lim WS, Wong WC, Wong CH, Ng TP, et al. (2017). The Asia-Pacific Clinical Practice Guidelines for the Management of Frailty. J Am Med Dir Assoc, 18(7):564-575. - PubMed
    1. Ma L, Tang Z, Zhang L, Sun F, Li Y, Chan P (2018). Prevalence of Frailty and Associated Factors in the Community-Dwelling Population of China. J Am Geriatr Soc, 66(3):559-564. - PubMed
    1. Siriwardhana DD, Hardoon S, Rait G, Weerasinghe MC, Walters KR (2018). Prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open, 8(3): e018195. - PMC - PubMed
    1. Gale CR, Cooper C, Sayer AA (2015). Prevalence of frailty and disability: findings from the English Longitudinal Study of Ageing. Age Ageing, 44(1): 162-5. - PMC - PubMed

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