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Frailty Is a Predictor of Future Dementia Risk
Frailty increases a person’s risk of dementia, but early intervention may be the key to prevention, according to a study published in JAMA Neurology.
David Ward, PhD, University of Queensland, Princess Alexandra Hospital, Queensland, Australia, and colleagues tracked the data of nearly 30,000 participants of 4 longitudinal studies in the United Kingdom and the United States, enabling them to detect changes in people’s health and function 20 years before they were diagnosed with dementia.
“The accumulation of age-related conditions is indicative of increasing frailty, which we found accelerates up to 9 years prior to a dementia diagnosis,” Dr Ward said. “Our findings show with every 4 to 5 additional health problems, there is on average a 40% higher risk of developing dementia, while for people who are fitter the risk is lower. This suggests frailty is not merely a consequence of undetected dementia but contributes to its onset."
To clarify the temporal relationship between frailty and incident dementia, the researchers investigated frailty trajectories in the years preceding dementia onset. Participant data came from 4 prospective cohort studies: the English Longitudinal Study of Ageing, the Health and Retirement Study, the Rush Memory and Aging Project, and the National Alzheimer Coordinating Center. Data were collected between 1997 and 2024 and were analysed from July 2023 to August 2024. The settings were retirement communities, national-level surveys, and a multi-clinic-based cohort. Included individuals were aged 60 years or older and without cognitive impairment at baseline.
The primary outcome was incident all-cause dementia ascertained through physician-derived diagnoses, self- and informant-report, and estimated classifications based on combinations of cognitive tests.
After exclusions, data from 29,849 participants were analysed. Bayesian generalised linear mixed regression models revealed accelerations in frailty trajectories 4 to 9 years before incident dementia. Overall, frailty was positively associated with dementia risk, with adjusted hazard ratios (aHRs) ranging from 1.18 to 1.73). This association held among participants whose time between frailty measurement and incident dementia exceeded the identified acceleration period (aHR range, 1.18 to 1.43).
“People age at different rates and the number of health problems that accumulate is captured by their degree of frailty,” Dr Ward said. “By understanding the connection between ageing, frailty and dementia we can use targeted intervention strategies to reduce risk and improve quality of life. This finding supports integrating frailty screening into routine check-ups and could be used to inform health programs which promote lifestyle interventions such as exercise and nutrition.”
Reference: https://jamanetwork.com/journals/jamaneurology/article-abstract/2826165
SOURCE: University of Queensland
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