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      Association Between Carotid Artery Intima-Media Thickness and Combinations of Mild Cognitive Impairment and Pre-Frailty in Older Adults

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          Abstract

          Carotid intima-media thickness (CIMT) has been proposed as a surrogate marker of cardiovascular disease. Mild cognitive impairment (MCI) and pre-frailty are reportedly associated with increased CIMT. As the evidence on the association of CIMT with combinations of MCI and pre-frailty is limited, this association is examined. A total of 231 older adults participated. MCI was defined according to clinical consensus or psychometric criteria by a dementia specialist, and considering detailed neuropsychological assessments. Also, pre-frailty was defined as subjects with frail component of 1 or 2. Carotid variables were measured using a B-mode ultrasound. The analysis of covariance (ANCOVA) was performed to assess independent differences in CIMT among the four groups, according to the cognitive function and frailty status after a multivariate adjustment. Increased CIMT is associated with combinations of MCI and pre-frailty. ANCOVA showed that CIMTs were significantly different among the four groups according to the cognitive function and frailty status. CIMTmax combined with MCI and pre-frailty was the thickest (1.04 ± 0.3 mm), whereas the CIMT of no MCI and no pre-frailty was the thinnest (0.82 ± 0.2 mm). The results suggest that combinations of MCI and pre-frailty are associated with increased CIMT in older adults.

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          Most cited references33

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          Association of Sleep-Disordered Breathing With Cognitive Function and Risk of Cognitive Impairment: A Systematic Review and Meta-analysis.

          Growing evidence suggests an association between sleep-disordered breathing (SDB) and cognitive decline in elderly persons. However, results from population-based studies have been conflicting, possibly owing to different methods to assess SDB or cognitive domains, making it difficult to draw conclusions on this association.
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            An adaptation of the Korean mini-mental state examination (K-MMSE) in elderly Koreans: demographic influence and population-based norms (the AGE study).

            The mini-mental state examination (MMSE) is a brief global instrument used to assess cognitive abilities, and has been translated into the K-MMSE. The clinical value of the K-MMSE is restricted by the small amount of normative data available, especially for the elderly population. We investigated the population-based data of K-MMSE scores to obtain the norms specific for the sociodemographic characteristics of elderly Koreans. The K-MMSE was applied to a cognitively normal sample of 977 subjects aged 60-84 years in Ansan, South Korea. We determined whether the sociodemographic characteristics were related to the K-MMSE scores and calculated the norms. The K-MMSE score was significantly associated with age, gender, and level of education, and this result was used to develop normative data with age, gender, and educational strata. The normative data based on age, gender, and level of education presented here are suitable for clinical use.
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              Prevalence of Frailty and Aging-Related Health Conditions in Older Koreans in Rural Communities: a Cross-Sectional Analysis of the Aging Study of Pyeongchang Rural Area

              Frailty has been previously studied in Western countries and the urban Korean population; however, the burden of frailty and geriatric conditions in the aging populations of rural Korean communities had not yet been determined. Thus, we established a population-based prospective study of adults aged ≥ 65 years residing in rural communities of Korea between October 2014 and December 2014. All participants underwent comprehensive geriatric assessment that encompassed the assessment of cognitive and physical function, depression, nutrition, and body composition using bioimpedance analysis. We determined the prevalence of frailty based on the Cardiovascular Health Study (CHS) and Korean version of FRAIL (K-FRAIL) criteria, as well as geriatric conditions. We recruited 382 adults (98% of eligible adults; mean age: 74 years; 56% women). Generally, sociodemographic characteristics were similar to those of the general rural Korean population. Common geriatric conditions included instrumental activity of daily living disability (39%), malnutrition risk (38%), cognitive dysfunction (33%), multimorbidity (32%), and sarcopenia (28%), while dismobility (8%), incontinence (8%), and polypharmacy (3%) were less common conditions. While more individuals were classified as frail according to the K-FRAIL criteria (27%) than the CHS criteria (17%), the CHS criteria were more strongly associated with prevalent geriatric conditions. Older Koreans living in rural communities have a significant burden of frailty and geriatric conditions that increase the risk of functional decline, poor quality of life, and mortality. The current study provides a basis to guide public health professionals and policy-makers in prioritizing certain areas of care and designing effective public health interventions to promote healthy aging of this vulnerable population.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                19 August 2019
                August 2019
                : 16
                : 16
                : 2978
                Affiliations
                [1 ]Department of Sport Rehabilitation, Dong-Ju College, Busan 49318, Korea
                [2 ]Health Convergence Medicine Research Group, Biomedical Research Institute, Pusan National University Hospital, 179, Gudeok-Ro, Seo-Gu, Busan 49241, Korea
                [3 ]Department of Health Care Science, Dong-A University, Busan 49315, Korea
                [4 ]Institute of Convergence Bio-Health, Dong-A University, Busan 49201, Korea
                Author notes
                [* ]Correspondence: htpark@ 123456dau.ac.kr ; Tel.: +82-51-200-7517
                [†]

                Both authors contributed equally to this manuscript.

                Author information
                https://orcid.org/0000-0003-2815-7248
                https://orcid.org/0000-0002-1976-0005
                Article
                ijerph-16-02978
                10.3390/ijerph16162978
                6719246
                31430926
                c11f0e81-95ee-4964-9d43-75d9fb8a5d31
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 30 June 2019
                : 11 August 2019
                Categories
                Article

                Public health
                mild cognitive impairment,pre-frailty,carotid intima-media thickness,cardiovascular disease,older adults

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