Frailty Linked to Greater Risk of Dementia

Frailty measurements may enable the identification of individuals at higher risk of dementia up to 9 years before the onset of the disorder, according to study results published in JAMA Neurology. According to the study authors, the findings demonstrate the potential utility of frailty measurements in strategies to prevent dementia and participant selection for clinical trials.

Researchers performed statistical analysis to identify associations between frailty index scores and dementia onset timelines for 29,849 participants aged ≥60 years with cognitive impairment at baseline. Participant data were derived from 4 prospective cohort studies, including the English Longitudinal Study of Ageing, the Health and Retirement Study, the Rush Memory and Aging Project, and the National Alzheimer Coordinating Center. Frailty index scores, a measure of underlying health state, were determined based on clinical data including symptoms, signs, disabilities, and diseases.

Key results include the following:

• Frailty was positively associated with dementia risk, with adjusted hazard ratios ranging from 1.18 (95% CI, 1.13 to 1.24) to 1.73 (95% CI, 1.57 to 1.92).
• Eight to 20 years before dementia onset, researchers identified an elevated degree of frailty.
• Four to 9 years before dementia onset, researchers identified an accelerated rate of decline in health and function as measured by frailty index.
• Among those who developed dementia, female participants showed higher frailty than male participants, with a greater disparity further from dementia onset.
• Even before the 4-to-9-year period of frailty acceleration before dementia onset, frailty was a robust risk factor of incident dementia.