Your competent? doctor has had years to come up with a protocol to prevent frailty post stroke.
Did that occur? NO? So, you don't have a functioning stroke doctor or hospital, do you? RUN AWAY!
So, your doctor isn't up to the task of new knowledge? I'd suggest forced retirement of the doctor if your hospital is any good at all!
Association of Frailty With Dementia and the Mediating Role of Brain Structure and Immunometabolic Signatures
Abstract
Background and Objectives
Physical
frailty is associated with a higher risk of developing dementia, but it
remains unclear whether this relationship is causal and whether the
biological biomarkers and neurologic underlying mechanisms are involved.
We aimed to elucidate the link between physical frailty and dementia,
establish their causal relationship, and investigate the underlying
biological mechanisms.
Methods
This
prospective cohort study was based on UK Biobank participants without
dementia at enrollment (between 2006 and 2010). Physical frailty was
defined by 5 criteria (weight loss, exhaustion, physical inactivity,
slow walking speed, and low grip strength). Incident dementia was
tracked through linked hospital admission records and death registries,
using the International Classification of Diseases, Tenth Revision
(ICD-10) codes. Cox proportional hazard regression models and
bidirectional Mendelian randomization (MR) analyses were used to
evaluate the causal association of physical frailty with incident
dementia. In addition, the potential roles of genetic background, brain
structures, and biological biomarkers in the association were evaluated
using structural equation modeling.
Results
Among
489,573 participants (mean age 57.03 years, 54.4% female), 8,900
dementia cases were documented over a median follow-up of 13.58 years.
Compared with nonfrail individuals, the risk of dementia was 50% higher
in those with prefrailty (hazard ratio [HR]:1.50, 95% CI 1.44–1.57) and
182% higher in those with frailty (HR: 2.82, 95% CI 2.61–3.04).
Participants with frailty and high genetic risk had the highest risk of
dementia compared with those with low genetic risk and nonfrailty (HR:
3.87, 95% CI 3.30–4.55 for high polygenic risk score; HR: 8.45, 95% CI
7.51–9.51 for APOE-ε4 carriers). The forward MR analysis
indicated a potential causal relationship between physical frailty and
dementia (odds ratio [OR]:1.79, 95% CI 1.03–3.12) while the reverse MR
suggested a null causal association (OR: 1.00, 95% CI 0.98–1.01).
Structural equation modeling points to genetic background and neurologic
and immunometabolic function as potential underlying mechanisms linking
physical frailty to dementia.
Discussion
Our
findings support the causal association between physical frailty and
dementia, which is possibly mediated through genetic background and
neurologic and immunometabolic function. However, this association
deserves close consideration because frailty may also be a correlative
marker of dementia vulnerability.
Get full access to this article
View all available purchase options and get full access to this article.
No comments:
Post a Comment