Klinik Araştırma
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Association Between Cognitive Function and Geriatric Syndromes in Community-Dwelling Older Adults

Yıl 2025, Cilt: 47 Sayı: 6, 1029 - 1039, 26.09.2025
https://doi.org/10.20515/otd.1720741

Öz

This study aimed to investigate the associations between cognitive function, geriatric syndromes (such as frailty, sarcopenia, and malnutrition), functional status, and common comorbidities in community-dwelling older adults. We hypothesized that cognitive impairment is closely related to multidimensional geriatric vulnerabilities beyond chronological aging alone. In this retrospective, cross-sectional analysis, data were obtained from 278 individuals aged 60 and above who attended Istanbul Training and Research Hospital between January 2024 and January 2025. Cognitive status was assessed using the Mini-Mental State Examination (MMSE). Additional assessments included the FRAIL scale, SARC-F, MNA-SF, handgrip strength, and Geriatric Depression Scale (GDS-SF). Biochemical markers and demographic, functional, and social parameters were also evaluated. Statistical analysis included univariate comparisons and multivariable logistic regression to determine independent predictors of cognitive impairment. Cognitive impairment was present in 17.3% of participants. In univariate analyses, cognitive impairment was significantly associated with older age, lower IADL scores, higher frailty and sarcopenia risk, malnutrition, depressive symptoms, and reduced handgrip strength. However, in multivariable analysis, only older age and lower IADL scores emerged as independent predictorsSocial disengagement and hearing problems were also more common in cognitively impaired individuals. Multivariate analysis revealed that increased age and lower IADL scores were independent predictors of cognitive impairment. This study highlights that cognitive decline in older adults is not an isolated phenomenon but is deeply intertwined with functional, nutritional, and psychosocial factors. Comprehensive geriatric assessment tools should be routinely used to identify individuals at risk. Interventions that preserve daily living abilities and promote nutrition and mental well-being may help delay cognitive deterioration.

Proje Numarası

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Kaynakça

  • 1. Smith PJ, Blumenthal JA, Babyak MA, et al. Effects of physical exercise on cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis. Am J Geriatr Psychiatry. 2020;28(6):673-683.
  • 2. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
  • 3. Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging. 2014;18(1):95-100.
  • 4. Wei J, Yin X, Liu Y, et al. Malnutrition and cognitive impairment among elderly individuals: a systematic review and meta-analysis. J Alzheimers Dis. 2019;72(1):177-190.
  • 5. Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672-2713.
  • 6. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
  • 7. Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res. 2009;43(4):411-431.
  • 8. Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11(11):1006-1012.
  • 9. Nebel RA, Aggarwal NT, Barnes LL, et al. Understanding the impact of sex and gender in Alzheimer’s disease: a call to action. Alzheimers Dement. 2018;14(9):1171-1183.
  • 10. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
  • 11. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16(7):601-608.
  • 12. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37-49.
  • 13. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev. 1996;54(1 Pt 2):S59-S65.
  • 14. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186
  • 15. Rolland Y, Lauwers-Cances V, Cournot M, et al. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. J Am Geriatr Soc. 2003;51(8):1120-1124.
  • 16. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14(8):531-532
  • 17. Gill TM, Allore HG, Gahbauer EA, Murphy TE. Change in disability after hospitalization or restricted activity in older persons. JAMA. 2010;304(17):1919-1928.
  • 18. Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) consensus group. J Nutr Health Aging. 2013;17(9):726-734.
  • 19. Ma L, Sha G, Li Y, Wang Y, Xu A. Cognitive frailty in China: results from China Comprehensive Geriatric Assessment Study. Front Med. 2017;11(4):490-494.
  • 20. Soysal P, Stubbs B, Lucato P, et al. Inflammation and frailty in the elderly: a systematic review and meta-analysis. Ageing Res Rev. 2016;31:1-8.
  • 21. Orsitto G, Fulvio F, Tria D, et al. Nutritional status in hospitalized elderly patients with mild cognitive impairment. Clin Nutr. 2009;28(1):100-102.
  • 22. Shatenstein B, Kergoat MJ. Nutrition and cognitive decline: does age modify the relationship? J Nutr Health Aging. 2012;16(9):760-764.
  • 23. Moore E, Mander A, Ames D, et al. Cognitive impairment and vitamin B12: a review. Int Psychogeriatr. 2012;24(4):541-556.
  • 24. Annweiler C, Llewellyn DJ, Beauchet O. Low serum vitamin D concentrations in Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2013;33(3):659-674.
  • 25. Ownby RL, Crocco E, Acevedo A, et al. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry. 2006;63(5):530-538.
  • 26. Donovan NJ, Amarasiriwardena C, Okereke OI, et al. Association of higher cortical amyloid burden with loneliness in cognitively normal older adults. JAMA Psychiatry. 2016;73(12):1230-1237.
  • 27. Deckers K, van Boxtel MP, Schiepers OJ, et al. Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies. Int J Geriatr Psychiatry. 2015;30(3):234-246.
  • 28. Fratiglioni L, Wang HX, Ericsson K, et al. Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet. 2000;355(9212):1315-1319.
  • 29. Wu YT, Beiser AS, Breteler MM, et al. The changing prevalence and incidence of dementia over time: current evidence. Nat Rev Neurol. 2017;13(6):327-339.
  • 30. Ioannidou S, Tsolaki M, Ginoudis A, Tamvakis A, Tsolaki A, Makedou K, Lymperaki E. Oxidative Stress Biomarkers as Preclinical Markers of Mild Cognitive Impairment: The Impact of Age and Sex. Journal of Personalized Medicine. 2025;15(5):171.
  • 31. Gupta DK, Chaudhuri A. The role of stress, inflammatory markers, and environmental determinants in cognitive decline and dementia: A systematic review of recent evidence. Medical Journal of Medical Research. 2025;16(1):53‑60
  • 32. Ates Bulut E, Soysal P, Dokuzlar O, Kılıç E, Yavuz I, Ulger Z. Prevalence of dementia and associated risk factors among community-dwelling elderly in Sivas, Turkey. NeuroSci. 2021;26(1):15-21. doi:10.30498/ns.2021.26354.
  • 33. Cankurtaran M, Yavuz B, Aydin OO, Soysal P, Isik AT. The relation of cognitive function with ADL and IADL in elderly living in the community in Kayseri. Turk J Geriatr. 2019;22(1):34-41.
  • 34. Anstey KJ, Cherbuin N, Herath PM. Development of a new method for assessing global risk of Alzheimer’s disease for use in population health approaches to prevention. Prev Sci. 2013;14(4):411-421.
  • 35. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40(9):922-935.

Toplumda Yaşayan Yaşli Erişkinlerde Bilişsel İşlev, Geriatrik Sendromlar Ve Komorbiditeler Arasindaki İlişki

Yıl 2025, Cilt: 47 Sayı: 6, 1029 - 1039, 26.09.2025
https://doi.org/10.20515/otd.1720741

Öz

Bu çalışmanın amacı, toplumda yaşayan yaşlı yetişkinlerde bilişsel işlev, geriatrik sendromlar (kırılganlık, sarkopeni ve yetersiz beslenme gibi), işlevsel durum ve yaygın komorbiditeler arasındaki ilişkileri araştırmaktı. Bilişsel bozukluğun, kronolojik yaşlanmanın ötesinde çok boyutlu geriatrik sorunlarla ilişkili olduğunu varsaydık.Bu retrospektif, kesitsel analizde, Ocak 2024 ile Ocak 2025 arasında İstanbul Eğitim ve Araştırma Hastanesi'ne başvuran 60 yaş ve üzeri 278 kişiden veriler elde edildi. Bilişsel durum, Mini-Mental Durum İncelemesi (MMSE) kullanılarak değerlendirildi. Ek değerlendirmeler arasında FRAIL ölçeği, SARC-F, MNA-SF, el kavrama gücü ve Geriatrik Depresyon Ölçeği (GDS-SF) yer aldı. Ayrıca biyokimyasal belirteçler ve demografik, işlevsel ve sosyal parametreler de değerlendirildi. İstatistiksel analiz, bilişsel bozukluğun bağımsız öngörücülerini belirlemek için tek değişkenli karşılaştırmalar ve çok değişkenli lojistik regresyon içeriyordu.Bilişsel bozukluk katılımcıların %17,3'ünde mevcuttu ve ileri yaş, günlük yaşamın enstrümantal aktivitelerinde (EGYA) azalan bağımsızlık, daha yüksek kırılganlık ve sarkopeni riski, yetersiz beslenme, depresif semptomlar ve daha düşük el kavrama gücü ile önemli ölçüde ilişkiliydi. Sosyal ve izolasyon bsorunları da bilişsel olarak bozuk bireylerde daha yaygındı. Çok değişkenli analiz, artan yaş ve düşük EGYA puanlarının bilişsel bozukluğun bağımsız öngörücüleri olduğunu ortaya koydu.Bu çalışma, yaşlı yetişkinlerde bilişsel gerilemenin izole bir durum olmadığını, ancak işlevsel, beslenme ve psikososyal faktörlerle derinlemesine iç içe olduğunu vurgulamaktadır. Risk altındaki bireyleri belirlemek için kapsamlı geriatrik değerlendirme araçları rutin olarak kullanılmalıdır. Günlük yaşam becerilerini koruyan ve beslenmeyi ve ruhsal refahı destekleyen müdahaleler bilişsel bozulmayı geciktirmeye yardımcı olabilir.

Proje Numarası

-

Kaynakça

  • 1. Smith PJ, Blumenthal JA, Babyak MA, et al. Effects of physical exercise on cognitive function in older adults with mild cognitive impairment: a systematic review and meta-analysis. Am J Geriatr Psychiatry. 2020;28(6):673-683.
  • 2. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31.
  • 3. Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group. J Nutr Health Aging. 2014;18(1):95-100.
  • 4. Wei J, Yin X, Liu Y, et al. Malnutrition and cognitive impairment among elderly individuals: a systematic review and meta-analysis. J Alzheimers Dis. 2019;72(1):177-190.
  • 5. Gorelick PB, Scuteri A, Black SE, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672-2713.
  • 6. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
  • 7. Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res. 2009;43(4):411-431.
  • 8. Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11(11):1006-1012.
  • 9. Nebel RA, Aggarwal NT, Barnes LL, et al. Understanding the impact of sex and gender in Alzheimer’s disease: a call to action. Alzheimers Dement. 2018;14(9):1171-1183.
  • 10. Folstein MF, Folstein SE, McHugh PR. "Mini-mental state": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198.
  • 11. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16(7):601-608.
  • 12. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17(1):37-49.
  • 13. Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the Mini Nutritional Assessment as part of the geriatric evaluation. Nutr Rev. 1996;54(1 Pt 2):S59-S65.
  • 14. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179-186
  • 15. Rolland Y, Lauwers-Cances V, Cournot M, et al. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. J Am Geriatr Soc. 2003;51(8):1120-1124.
  • 16. Malmstrom TK, Morley JE. SARC-F: a simple questionnaire to rapidly diagnose sarcopenia. J Am Med Dir Assoc. 2013;14(8):531-532
  • 17. Gill TM, Allore HG, Gahbauer EA, Murphy TE. Change in disability after hospitalization or restricted activity in older persons. JAMA. 2010;304(17):1919-1928.
  • 18. Kelaiditi E, Cesari M, Canevelli M, et al. Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) consensus group. J Nutr Health Aging. 2013;17(9):726-734.
  • 19. Ma L, Sha G, Li Y, Wang Y, Xu A. Cognitive frailty in China: results from China Comprehensive Geriatric Assessment Study. Front Med. 2017;11(4):490-494.
  • 20. Soysal P, Stubbs B, Lucato P, et al. Inflammation and frailty in the elderly: a systematic review and meta-analysis. Ageing Res Rev. 2016;31:1-8.
  • 21. Orsitto G, Fulvio F, Tria D, et al. Nutritional status in hospitalized elderly patients with mild cognitive impairment. Clin Nutr. 2009;28(1):100-102.
  • 22. Shatenstein B, Kergoat MJ. Nutrition and cognitive decline: does age modify the relationship? J Nutr Health Aging. 2012;16(9):760-764.
  • 23. Moore E, Mander A, Ames D, et al. Cognitive impairment and vitamin B12: a review. Int Psychogeriatr. 2012;24(4):541-556.
  • 24. Annweiler C, Llewellyn DJ, Beauchet O. Low serum vitamin D concentrations in Alzheimer’s disease: a systematic review and meta-analysis. J Alzheimers Dis. 2013;33(3):659-674.
  • 25. Ownby RL, Crocco E, Acevedo A, et al. Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry. 2006;63(5):530-538.
  • 26. Donovan NJ, Amarasiriwardena C, Okereke OI, et al. Association of higher cortical amyloid burden with loneliness in cognitively normal older adults. JAMA Psychiatry. 2016;73(12):1230-1237.
  • 27. Deckers K, van Boxtel MP, Schiepers OJ, et al. Target risk factors for dementia prevention: a systematic review and Delphi consensus study on the evidence from observational studies. Int J Geriatr Psychiatry. 2015;30(3):234-246.
  • 28. Fratiglioni L, Wang HX, Ericsson K, et al. Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet. 2000;355(9212):1315-1319.
  • 29. Wu YT, Beiser AS, Breteler MM, et al. The changing prevalence and incidence of dementia over time: current evidence. Nat Rev Neurol. 2017;13(6):327-339.
  • 30. Ioannidou S, Tsolaki M, Ginoudis A, Tamvakis A, Tsolaki A, Makedou K, Lymperaki E. Oxidative Stress Biomarkers as Preclinical Markers of Mild Cognitive Impairment: The Impact of Age and Sex. Journal of Personalized Medicine. 2025;15(5):171.
  • 31. Gupta DK, Chaudhuri A. The role of stress, inflammatory markers, and environmental determinants in cognitive decline and dementia: A systematic review of recent evidence. Medical Journal of Medical Research. 2025;16(1):53‑60
  • 32. Ates Bulut E, Soysal P, Dokuzlar O, Kılıç E, Yavuz I, Ulger Z. Prevalence of dementia and associated risk factors among community-dwelling elderly in Sivas, Turkey. NeuroSci. 2021;26(1):15-21. doi:10.30498/ns.2021.26354.
  • 33. Cankurtaran M, Yavuz B, Aydin OO, Soysal P, Isik AT. The relation of cognitive function with ADL and IADL in elderly living in the community in Kayseri. Turk J Geriatr. 2019;22(1):34-41.
  • 34. Anstey KJ, Cherbuin N, Herath PM. Development of a new method for assessing global risk of Alzheimer’s disease for use in population health approaches to prevention. Prev Sci. 2013;14(4):411-421.
  • 35. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40(9):922-935.
Toplam 35 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Geriatri ve Gerontoloji
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Özlem Yılmaz 0000-0001-9868-2828

Tugce Nur Turkoglu 0009-0002-0762-0053

Nurdan Senturk Durmus 0000-0003-4604-7456

Pinar Kucukdagli 0000-0002-3632-8281

Hanife Usta Atmaca 0000-0002-6591-4810

Proje Numarası -
Yayımlanma Tarihi 26 Eylül 2025
Gönderilme Tarihi 16 Haziran 2025
Kabul Tarihi 16 Eylül 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 6

Kaynak Göster

Vancouver Yılmaz Ö, Turkoglu TN, Senturk Durmus N, Kucukdagli P, Usta Atmaca H. Association Between Cognitive Function and Geriatric Syndromes in Community-Dwelling Older Adults. Osmangazi Tıp Dergisi. 2025;47(6):1029-3.


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