Sex Moderates the Association between Frailty and Mild Behavioral Impairment

D. X. Guan; K. Rockwood; E. E. Smith; Zahinoor Ismail

doi:10.14283/jpad.2022.61

Sex Moderates the Association between Frailty and Mild Behavioral Impairment

D. X. Guan, K. Rockwood, E. E. Smith, Zahinoor Ismail

Producción científica: Contribución a una revista › Artículo › revisión exhaustiva

14 Citas (Scopus)

Resumen

Background: Frailty has been associated with cognitive markers of dementia but its relationship with behavioral markers of dementia are poorly understood. Objectives: To investigate the association between frailty and mild behavioral impairment (MBI), and whether this association is moderated by sex. Design: Cross-sectional observational study. Participants/Setting: 219 non-dementia participants (cognitively normal and mild cognitive impairment) from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. Measurements: Frailty was measured using the frailty index (FI) with higher scores indicating more health deficits/greater frailty. MBI symptoms were derived from Neuropsychiatric Inventory Questionnaire scores using a published algorithm with a cut-off of >0 indicating MBI symptom presence and higher scores indicating greater severity. Multivariable logistic and linear regressions adjusted for age, sex, education, and cognitive diagnosis were used to test the association between FI and MBI symptom presence and severity, respectively, with MBI as the outcome variable. An FI-by-sex interaction term was included to test for sex-dependent effects. Results: The FI mean and SD across the entire cohort was 0.14 ± 0.06 (median = 0.14, IQR = 0.09–0.17, range = 0.02–0.38). Higher FI scores were associated with the presence of MBI symptoms both globally and in the domains of decreased motivation, affective dysregulation, and psychosis. Higher FI scores were also associated with more severe MBI symptoms in a sex-dependent manner: both sexes reported similarly low MBI symptom severity at low (−1 SD) levels of FI but males reported 1.9x higher MBI symptom severity relative to females at high (+1 SD) levels of FI. Conclusions: The FI is associated with both the presence and severity of MBI, especially for males. This suggests that screening for early dementia risk should incorporate assessments of MBI for patients with frailty, and assessments of frailty for patients with MBI.

Idioma original	English
Publicación	The journal of prevention of Alzheimer's disease
DOI	https://doi.org/10.14283/jpad.2022.61
Estado	Accepted/In press - 2022

Nota bibliográfica

Funding Information:
Conflicts of Interest: Financial Disclosure: Guan, Smith - no declared conflicts; Ismail - honoraria / consulting fees from Lundbeck/Otsuka, outside the submitted work, consulting fees from Acadia, Biogen, and Roche, all paid to institution. Rockwood - has asserted copyright of the Clinical Frailty Scale through Dalhousie University’s Industry, Liaison, and Innovation Office. Use is free for education, research, and not-for-profit health care. Users agree not to change or commercialize the scale. In addition to academic and hospital appointments, KR is Co-founder of Ardea Outcomes, which (as DGI Clinical) in the last three years has contracts with pharmaceutical and device manufacturers (Danone, Hollister, INmune, Novartis, Takeda) on individualized outcome measurement. In 2020, he attended an advisory board meeting with Nutricia on dementia, and chaired a Scientific Workshop & Technical Review Panel on frailty for the Singapore National Research Foundation. Otherwise, any personal fees are for invited guest lectures, rounds and academic symposia, received directly from event organizers, for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging. The Canadian Consortium on Neurodegeneration in Aging is supported by a grant from the Canadian Institutes of Health Research with funding from several partners.

Funding Information:
Funding: This study received funding from Canadian Consortium on Neurodegeneration in Aging and the Canadian Frailty Network as part of the 2021 Summer Student Award. Kenneth Rockwood has asserted copyright of the Clinical Frailty Scale through Dalhousie University’s Industry, Liaison, and Innovation Office. Use is free for education, research, and not-for-profit health care. Users agree not to change or commercialize the scale. In addition to academic and hospital appointments, KR is Co-founder of Ardea Outcomes, which (as DGI Clinical) in the last three years has contracts with pharmaceutical and device manufacturers (Danone, Hollister, INmune, Novartis, Takeda) on individualized outcome measurement. In 2020, he attended an advisory board meeting with Nutricia on dementia, and chaired a Scientific Workshop & Technical Review Panel on frailty for the Singapore National Research Foundation. Otherwise, any personal fees are for invited guest lectures, rounds and academic symposia, received directly from event organizers, for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, itself funded by the Canadian Institutes for Health Research, the Alzheimer Society of Canada, and several other charities.

Publisher Copyright:
© 2022, The Author(s).

ASJC Scopus Subject Areas

Clinical Neurology
Psychiatry and Mental health

PubMed: MeSH publication types

Observational Study
Journal Article
Research Support, Non-U.S. Gov't

ODS de las Naciones Unidas

Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible

Acceder al documento

10.14283/jpad.2022.61

Otros archivos y enlaces

Citar esto

@article{b94e0ab3e85d41f783c33107b1e4d113,

title = "Sex Moderates the Association between Frailty and Mild Behavioral Impairment",

abstract = "Background: Frailty has been associated with cognitive markers of dementia but its relationship with behavioral markers of dementia are poorly understood. Objectives: To investigate the association between frailty and mild behavioral impairment (MBI), and whether this association is moderated by sex. Design: Cross-sectional observational study. Participants/Setting: 219 non-dementia participants (cognitively normal and mild cognitive impairment) from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. Measurements: Frailty was measured using the frailty index (FI) with higher scores indicating more health deficits/greater frailty. MBI symptoms were derived from Neuropsychiatric Inventory Questionnaire scores using a published algorithm with a cut-off of >0 indicating MBI symptom presence and higher scores indicating greater severity. Multivariable logistic and linear regressions adjusted for age, sex, education, and cognitive diagnosis were used to test the association between FI and MBI symptom presence and severity, respectively, with MBI as the outcome variable. An FI-by-sex interaction term was included to test for sex-dependent effects. Results: The FI mean and SD across the entire cohort was 0.14 ± 0.06 (median = 0.14, IQR = 0.09–0.17, range = 0.02–0.38). Higher FI scores were associated with the presence of MBI symptoms both globally and in the domains of decreased motivation, affective dysregulation, and psychosis. Higher FI scores were also associated with more severe MBI symptoms in a sex-dependent manner: both sexes reported similarly low MBI symptom severity at low (−1 SD) levels of FI but males reported 1.9x higher MBI symptom severity relative to females at high (+1 SD) levels of FI. Conclusions: The FI is associated with both the presence and severity of MBI, especially for males. This suggests that screening for early dementia risk should incorporate assessments of MBI for patients with frailty, and assessments of frailty for patients with MBI.",

author = "Guan, {D. X.} and K. Rockwood and Smith, {E. E.} and Zahinoor Ismail",

note = "Funding Information: Conflicts of Interest: Financial Disclosure: Guan, Smith - no declared conflicts; Ismail - honoraria / consulting fees from Lundbeck/Otsuka, outside the submitted work, consulting fees from Acadia, Biogen, and Roche, all paid to institution. Rockwood - has asserted copyright of the Clinical Frailty Scale through Dalhousie University{\textquoteright}s Industry, Liaison, and Innovation Office. Use is free for education, research, and not-for-profit health care. Users agree not to change or commercialize the scale. In addition to academic and hospital appointments, KR is Co-founder of Ardea Outcomes, which (as DGI Clinical) in the last three years has contracts with pharmaceutical and device manufacturers (Danone, Hollister, INmune, Novartis, Takeda) on individualized outcome measurement. In 2020, he attended an advisory board meeting with Nutricia on dementia, and chaired a Scientific Workshop & Technical Review Panel on frailty for the Singapore National Research Foundation. Otherwise, any personal fees are for invited guest lectures, rounds and academic symposia, received directly from event organizers, for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging. The Canadian Consortium on Neurodegeneration in Aging is supported by a grant from the Canadian Institutes of Health Research with funding from several partners. Funding Information: Funding: This study received funding from Canadian Consortium on Neurodegeneration in Aging and the Canadian Frailty Network as part of the 2021 Summer Student Award. Kenneth Rockwood has asserted copyright of the Clinical Frailty Scale through Dalhousie University{\textquoteright}s Industry, Liaison, and Innovation Office. Use is free for education, research, and not-for-profit health care. Users agree not to change or commercialize the scale. In addition to academic and hospital appointments, KR is Co-founder of Ardea Outcomes, which (as DGI Clinical) in the last three years has contracts with pharmaceutical and device manufacturers (Danone, Hollister, INmune, Novartis, Takeda) on individualized outcome measurement. In 2020, he attended an advisory board meeting with Nutricia on dementia, and chaired a Scientific Workshop & Technical Review Panel on frailty for the Singapore National Research Foundation. Otherwise, any personal fees are for invited guest lectures, rounds and academic symposia, received directly from event organizers, for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, itself funded by the Canadian Institutes for Health Research, the Alzheimer Society of Canada, and several other charities. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

doi = "10.14283/jpad.2022.61",

language = "English",

journal = "The journal of prevention of Alzheimer's disease",

issn = "2274-5807",

publisher = "Springer International Publishing AG",

}

TY - JOUR

T1 - Sex Moderates the Association between Frailty and Mild Behavioral Impairment

AU - Guan, D. X.

AU - Rockwood, K.

AU - Smith, E. E.

AU - Ismail, Zahinoor

N1 - Funding Information: Conflicts of Interest: Financial Disclosure: Guan, Smith - no declared conflicts; Ismail - honoraria / consulting fees from Lundbeck/Otsuka, outside the submitted work, consulting fees from Acadia, Biogen, and Roche, all paid to institution. Rockwood - has asserted copyright of the Clinical Frailty Scale through Dalhousie University’s Industry, Liaison, and Innovation Office. Use is free for education, research, and not-for-profit health care. Users agree not to change or commercialize the scale. In addition to academic and hospital appointments, KR is Co-founder of Ardea Outcomes, which (as DGI Clinical) in the last three years has contracts with pharmaceutical and device manufacturers (Danone, Hollister, INmune, Novartis, Takeda) on individualized outcome measurement. In 2020, he attended an advisory board meeting with Nutricia on dementia, and chaired a Scientific Workshop & Technical Review Panel on frailty for the Singapore National Research Foundation. Otherwise, any personal fees are for invited guest lectures, rounds and academic symposia, received directly from event organizers, for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging. The Canadian Consortium on Neurodegeneration in Aging is supported by a grant from the Canadian Institutes of Health Research with funding from several partners. Funding Information: Funding: This study received funding from Canadian Consortium on Neurodegeneration in Aging and the Canadian Frailty Network as part of the 2021 Summer Student Award. Kenneth Rockwood has asserted copyright of the Clinical Frailty Scale through Dalhousie University’s Industry, Liaison, and Innovation Office. Use is free for education, research, and not-for-profit health care. Users agree not to change or commercialize the scale. In addition to academic and hospital appointments, KR is Co-founder of Ardea Outcomes, which (as DGI Clinical) in the last three years has contracts with pharmaceutical and device manufacturers (Danone, Hollister, INmune, Novartis, Takeda) on individualized outcome measurement. In 2020, he attended an advisory board meeting with Nutricia on dementia, and chaired a Scientific Workshop & Technical Review Panel on frailty for the Singapore National Research Foundation. Otherwise, any personal fees are for invited guest lectures, rounds and academic symposia, received directly from event organizers, for presentations on frailty. He is Associate Director of the Canadian Consortium on Neurodegeneration in Aging, itself funded by the Canadian Institutes for Health Research, the Alzheimer Society of Canada, and several other charities. Publisher Copyright: © 2022, The Author(s).

PY - 2022

Y1 - 2022

N2 - Background: Frailty has been associated with cognitive markers of dementia but its relationship with behavioral markers of dementia are poorly understood. Objectives: To investigate the association between frailty and mild behavioral impairment (MBI), and whether this association is moderated by sex. Design: Cross-sectional observational study. Participants/Setting: 219 non-dementia participants (cognitively normal and mild cognitive impairment) from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. Measurements: Frailty was measured using the frailty index (FI) with higher scores indicating more health deficits/greater frailty. MBI symptoms were derived from Neuropsychiatric Inventory Questionnaire scores using a published algorithm with a cut-off of >0 indicating MBI symptom presence and higher scores indicating greater severity. Multivariable logistic and linear regressions adjusted for age, sex, education, and cognitive diagnosis were used to test the association between FI and MBI symptom presence and severity, respectively, with MBI as the outcome variable. An FI-by-sex interaction term was included to test for sex-dependent effects. Results: The FI mean and SD across the entire cohort was 0.14 ± 0.06 (median = 0.14, IQR = 0.09–0.17, range = 0.02–0.38). Higher FI scores were associated with the presence of MBI symptoms both globally and in the domains of decreased motivation, affective dysregulation, and psychosis. Higher FI scores were also associated with more severe MBI symptoms in a sex-dependent manner: both sexes reported similarly low MBI symptom severity at low (−1 SD) levels of FI but males reported 1.9x higher MBI symptom severity relative to females at high (+1 SD) levels of FI. Conclusions: The FI is associated with both the presence and severity of MBI, especially for males. This suggests that screening for early dementia risk should incorporate assessments of MBI for patients with frailty, and assessments of frailty for patients with MBI.

AB - Background: Frailty has been associated with cognitive markers of dementia but its relationship with behavioral markers of dementia are poorly understood. Objectives: To investigate the association between frailty and mild behavioral impairment (MBI), and whether this association is moderated by sex. Design: Cross-sectional observational study. Participants/Setting: 219 non-dementia participants (cognitively normal and mild cognitive impairment) from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study. Measurements: Frailty was measured using the frailty index (FI) with higher scores indicating more health deficits/greater frailty. MBI symptoms were derived from Neuropsychiatric Inventory Questionnaire scores using a published algorithm with a cut-off of >0 indicating MBI symptom presence and higher scores indicating greater severity. Multivariable logistic and linear regressions adjusted for age, sex, education, and cognitive diagnosis were used to test the association between FI and MBI symptom presence and severity, respectively, with MBI as the outcome variable. An FI-by-sex interaction term was included to test for sex-dependent effects. Results: The FI mean and SD across the entire cohort was 0.14 ± 0.06 (median = 0.14, IQR = 0.09–0.17, range = 0.02–0.38). Higher FI scores were associated with the presence of MBI symptoms both globally and in the domains of decreased motivation, affective dysregulation, and psychosis. Higher FI scores were also associated with more severe MBI symptoms in a sex-dependent manner: both sexes reported similarly low MBI symptom severity at low (−1 SD) levels of FI but males reported 1.9x higher MBI symptom severity relative to females at high (+1 SD) levels of FI. Conclusions: The FI is associated with both the presence and severity of MBI, especially for males. This suggests that screening for early dementia risk should incorporate assessments of MBI for patients with frailty, and assessments of frailty for patients with MBI.

UR - http://www.scopus.com/inward/record.url?scp=85132389860&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85132389860&partnerID=8YFLogxK

U2 - 10.14283/jpad.2022.61

DO - 10.14283/jpad.2022.61

M3 - Article

C2 - 36281673

AN - SCOPUS:85132389860

SN - 2274-5807

JO - The journal of prevention of Alzheimer's disease

JF - The journal of prevention of Alzheimer's disease

ER -

Sex Moderates the Association between Frailty and Mild Behavioral Impairment

Resumen

Nota bibliográfica

ASJC Scopus Subject Areas

PubMed: MeSH publication types

ODS de las Naciones Unidas

Acceder al documento

Otros archivos y enlaces

Huella

Citar esto