Self-reported fatigue as a risk index for dementia diagnosis

Symeon H Panagiotakis; Panagiotis Simos; Ioannis Zaganas; Maria Basta; Garyfalia S Perysinaki; Nikolaos Fountoulakis; Maria Giaka; Stefania Kapetanaki; Irini Koutentaki; Antonios Bertsias; George Duijker; Nikolaos Scarmeas; Chariklia Tziraki; Christos Lionis; Alexandros Vgontzas; Dimitrios T Boumpas

doi:10.1007/s41999-017-0020-4

Self-reported fatigue as a risk index for dementia diagnosis

Eur Geriatr Med. 2018 Apr;9(2):211-217. doi: 10.1007/s41999-017-0020-4. Epub 2018 Mar 14.

Authors

Symeon H Panagiotakis¹, Panagiotis Simos^{2

3}, Ioannis Zaganas⁴, Maria Basta², Garyfalia S Perysinaki⁵, Nikolaos Fountoulakis⁶, Maria Giaka⁶, Stefania Kapetanaki⁴, Irini Koutentaki², Antonios Bertsias⁷, George Duijker⁷, Nikolaos Scarmeas⁸, Chariklia Tziraki⁹, Christos Lionis⁷, Alexandros Vgontzas², Dimitrios T Boumpas^{10

11}

Affiliations

¹ Internal Medicine Department, Heraklion University Hospital, Voutes, 71003, Heraklion, Crete, Greece. simeongpan@hotmail.com.
² Psychiatry Department, Medical School, University of Crete, Heraklion, Crete, Greece.
³ Institute of Computer Science, Computational Biomedicine Laboratory, Foundation for Research and Technology, Heraklion, Greece.
⁴ Neurology Department, Medical School, University of Crete, Heraklion, Crete, Greece.
⁵ Rethymnon General Hospital, Rethymnon, Crete, Greece.
⁶ Internal Medicine Department, Heraklion University Hospital, Voutes, 71003, Heraklion, Crete, Greece.
⁷ Clinic of Social and Family Medicine, Medical School, University of Crete, Heraklion, Crete, Greece.
⁸ Neurology Department, Medical School, University of Athens, Athens, Greece.
⁹ MELABEV, Research Institute, Community Elders Clubs and Institute for Gerontological Data Bases, Hebrew University, Jerusalem, Israel.
¹⁰ 4th Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
¹¹ University of Cyprus, Medical School, Nicosia, Cyprus.

PMID: 34654268
DOI: 10.1007/s41999-017-0020-4

Abstract

Introduction: Cognitive impairment and frailty are major problems of older age. This study aims to explore the association between frailty and cognitive impairment in a rural cohort of older subjects in southern Europe (Cretan Aging Cohort).

Methods: Community-based, primary care, cross-sectional, study in the Heraklion Prefecture, Crete, Greece. Four hundred and two persons aged 60-100 years from the Cretan Aging Cohort [100 with dementia, 175 with mild cognitive impairment (MCI) and 127 cognitively non-impaired] were enrolled, mostly rural dwellers (86.2%). Frailty was assessed with the Simple "Frail" Questionnaire Screening Tool. Demographic data, BMI, Mini-Mental State Examination scores (MMSE), severity of dementia according to the Clinical Dementia Rating Scale, and depressive symptoms according to the Geriatric Depression Scale (GDS) were recorded.

Results: Frailty was present in 17% of persons with dementia (73.8% of mild severity), in 6.3% of persons with MCI and in 8.7% of cognitively non-impaired persons (P < 0.05). Among the various frailty variables, fatigue and difficulty walking were significantly more frequently reported by persons with dementia. Each frailty variable and the frailty score correlated negatively with MMSE score and positively with GDS score and polypharmacy. Multivariate analysis revealed that reported fatigue improved the identification of dementia in addition to MMSE, significantly and independently of symptoms of depression (P = 0.04).

Conclusion: Frailty rates are significantly higher in persons with dementia. In this predominantly rural cohort of older subjects, reported fatigue could serve as a marker of physical decline and a complementary index for referral for further neuropsychological and neuropsychiatric evaluation.

Keywords: Cognitive impairment; Fatigue; Frailty.