Identificação de biomarcadores de fragilidade cognitiva em idosos da comunidade

Abstract

Introduction: The increase in life expectancy worldwide is an alert regarding the epidemiological profile of the older population, now affected mainly by chronic noncommunicable diseases. Cognitive decline is a relevant aspect related to aging, as it is a condition that can predict dementia and other negative health outcomes. Cognitive frailty (CF), defined as “a heterogeneous clinical manifestation characterized by the simultaneous presence of physical frailty and cognitive decline, characterized by a score of 0.5 on the Clinical Dementia Rating (CDR) questionnaire” can be a predictor of functional disability, hospitalization and death, so the early diagnosis of this condition can be crucial to develop preventive practices and pharmacological or nonpharmacological interventions. Cognitive frailty has two subtypes: potentially reversible cognitive frailty and reversible cognitive frailty. And, despite this well-defined construct, there is still great variability in the literature on the ways in which CF is operationalized. Thus, it is extremely important to identify biomarkers that can accurately diagnose cognitive frailty. The biomarker is an “indicator of normal biological processes, pathogenic processes, or responses to an exposure or therapeutic intervention,” according to the U.S Food and Drug Administration (FDA) and the National Institutes of Health (NIH). And there are criteria defined by The American Federation of Aging Research for the biomarker to be considered aging. When talking about biomarkers related to cognitive impairment, there is a consensus in the literature on markers with accuracy for the diagnosis of Alzheimer's disease (AD), however, as cognitive frailty can precede AD and other types of dementia, it is extremely pertinent to identify the biomarkers related to this condition. Objective: Perform a narrative review of the literature, seeking to identify the biomarkers associated with cognitive frailty. Methodology: Searches for articles of interest were carried out in the PUBMed, Medical Literature Analysis and Retrievel System Online (MEDLINE), Elsevier Biomedical Database (EMBASE), Scientific Electronic Library (SCIELO) and Online Latin American and Caribbean Heath Science Literature databases (MEDLINE). LILACS) from April 2022 to August 2022. Results: The search resulted in a total of 43 articles, and after analyzing the inclusion and exclusion criteria, only 4 articles were included in this review. Discussion: The included studies show a wide range of biomarkers. It is observed that in the literature there is a great lack of studies of good methodological quality that focus on the identification of specific biomarkers for cognitive frailty. Conclusion: The findings found in this review highlight the need to standardize the operationalization of cognitive frailty. Future research should be encouraged in order to clarify precise tools to diagnose CF and identify biomarkers that, in addition to providing the CF diagnosis, may be accessible and easy to apply.