Abstract
Main Problem: Frailty is an established risk factor for cognitive decline and Alzheimer's disease. Few studies have examined the longitudinal relationship between frailty and cognition. Methods: Participants of Rush Memory and Aging project (n = 625, 67.5% female, 83.2 ± 5.9 years at baseline) underwent annual clinical evaluations (average follow-up 5.6 ± 3.7 years) followed by neuropathologic assessment after death. A frailty index was calculated from 41 health variables at each evaluation. Clinical diagnosis of MCI and/or dementia was ascertained by clinical data review (blinded to neuropathological data) after death. Age, sex, education, and neuropathological burden (10-item index) were evaluated as covariates. Frailty trajectories were calculated using a mixed effects model. Results: At baseline the mean frailty index = 0.24 ± 0.12 and increased at rate of 0.026 or ~1 deficit per year. At death, 27.7% of the sample had MCI, and 38.6% had dementia. Frailty trajectories were significantly steeper among those individuals who were ultimately diagnosed as clinically impaired prior to death, even after controlling for age, sex, education, and neuropathological index. Conclusions: Findings suggest a strong link between health status (frailty index) and dementia, even after considering neuropathology. Frailty trajectories were associated with risk for MCI and dementia, underscoring the importance of addressing frailty to manage dementia risk.
| Original language | English |
|---|---|
| Pages (from-to) | 250-256 |
| Number of pages | 7 |
| Journal | Aging Medicine |
| Volume | 4 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Dec 2021 |
Bibliographical note
Funding Information:Lindsay Wallace is supported by a doctoral fellowship from the Canadian Institutes of Health Research (CIHR). Melissa Andrew’s work on frailty and dementia is part of a Canadian Consortium on Neurodegeneration in Aging (CCNA) investigation into how multi-morbidity modifies the risk of dementia and the patterns of disease expression (Team 14). The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations. Kenneth Rockwood’s work on frailty and cognition is supported by CIHR PJT-156114 and by the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research. The MAP is supported by NIH grant R01AG17917.
Funding Information:
Lindsay Wallace is supported by a doctoral fellowship from the Canadian Institutes of Health Research (CIHR). Melissa Andrew’s work on frailty and dementia is part of a Canadian Consortium on Neurodegeneration in Aging (CCNA) investigation into how multi‐morbidity modifies the risk of dementia and the patterns of disease expression (Team 14). The CCNA receives funding from the Canadian Institutes of Health Research (CNA‐137794) and partner organizations. Kenneth Rockwood’s work on frailty and cognition is supported by CIHR PJT‐156114 and by the Dalhousie Medical Research Foundation Kathryn Allen Weldon Chair of Alzheimer Disease Research. The MAP is supported by NIH grant R01AG17917.
Funding Information:
Melissa Andrew reports grants from GSK, Pfizer, and Sanofi unrelated to the current work. David Bennett reports grants from the National Institutes of Health (NIH). Kenneth Rockwood reports personal fees from Lundbeck for attending an advisory board meeting in 2017. Kenneth Rockwood is President and Chief Science Officer of DGI Clinical, which in the last 5 years has contracts with pharma and device manufacturers (Baxter, Baxalta, Shire, Hollister, Nutricia, Roche, Otsuka) on individualized outcome measurement. Otherwise, any personal fees are for invited guest lectures and academic symposia, received directly from event organizers, chiefly for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, which is funded by the Canadian Institutes of Health Research, and with additional funding from the Alzheimer Society of Canada and several other charities, as well as, in its first phase (2013–2018), from Pfizer Canada and Sanofi Canada. He receives career support from the Dalhousie Medical Research Foundation as the Kathryn Allen Weldon Professor of Alzheimer Research, and research support from the Canadian Institutes of Health Research, the Nova Scotia Health Research Foundation, the Capital Health Research Fund, and the Fountain Family Innovation Fund of the Nova Scotia Health Authority Foundation.
Publisher Copyright:
© 2021 The Authors. Aging Medicine published by Beijing Hospital and John Wiley & Sons Australia, Ltd.
ASJC Scopus Subject Areas
- Ageing
- Geriatrics and Gerontology
PubMed: MeSH publication types
- Journal Article