Most people who work in aged care have a fair idea of what is meant by cognitive impairment or decline, and we have some moderately robust instruments for detecting it and measuring change over time. Frailty is much more difficult to define, but like hard core pornography (Stewart, Reference Stewart1964), many of us “know it when we see it.”
The editorial team at International Psychogeriatrics has chosen the paper by St. John et al. (Reference John, Tyas, Griffith and Menec2017) that follows this commentary in the current issue of the journal, as the paper of the month for this issue. Using a large sample with an excellent response rate and well-validated measures of both cognitive function and physical frailty, these authors have shown that both cognitive impairment and frailty predict death over a five-year follow-up period and that the effects are both independent and cumulative. This is quite important. Frailty models that include cognition will be more robustly predictive of mortality than those that do not. The results reinforce longstanding findings that show general health and cognitive status to be strongly related. The effect of frailty and cognitive impairment was seen across the entire range of both the measures employed to measure these things. Risk may be apparent across the entire spectrum of both phenomena and so interventions that improve cognitive outcomes (e.g. education) or reduce the chance of becoming frail (e.g. physical activity), may have worthwhile effects on large populations.
It may well be true that “tis impossible to be sure of anything but Death and Taxes” (Bullock, Reference Bullock1716), but there is a prospect that with specific population interventions, one at least of these may be delayed or diminished over time.
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Most people who work in aged care have a fair idea of what is meant by cognitive impairment or decline, and we have some moderately robust instruments for detecting it and measuring change over time. Frailty is much more difficult to define, but like hard core pornography (Stewart, Reference Stewart1964), many of us “know it when we see it.”
The editorial team at International Psychogeriatrics has chosen the paper by St. John et al. (Reference John, Tyas, Griffith and Menec2017) that follows this commentary in the current issue of the journal, as the paper of the month for this issue. Using a large sample with an excellent response rate and well-validated measures of both cognitive function and physical frailty, these authors have shown that both cognitive impairment and frailty predict death over a five-year follow-up period and that the effects are both independent and cumulative. This is quite important. Frailty models that include cognition will be more robustly predictive of mortality than those that do not. The results reinforce longstanding findings that show general health and cognitive status to be strongly related. The effect of frailty and cognitive impairment was seen across the entire range of both the measures employed to measure these things. Risk may be apparent across the entire spectrum of both phenomena and so interventions that improve cognitive outcomes (e.g. education) or reduce the chance of becoming frail (e.g. physical activity), may have worthwhile effects on large populations.
It may well be true that “tis impossible to be sure of anything but Death and Taxes” (Bullock, Reference Bullock1716), but there is a prospect that with specific population interventions, one at least of these may be delayed or diminished over time.