JAMA Neurol

Frailty trajectories may predict dementia onset

November 18, 2024

Frailty assessments could be instrumental in identifying high-risk populations for prioritized enrollment in clinical trials focused on dementia prevention and treatment. Frailty may also serve as a valuable upstream target for implementing behavioral and societal strategies aimed at reducing dementia risk.

Study details

Participant data were sourced 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 collection occurred between 1997 and 2024, with analysis conducted from July 2023 to August 2024. The studies involved participants from retirement communities, national surveys, and a multiclinic cohort. All included individuals were aged 60 and older and had no cognitive impairment at baseline. Additionally, demographic information such as age, sex, education level, ethnicity, and a baseline frailty index score were collected.

Findings

Data from 29,849 individuals (mean age 71.6 years; 62% female) were analyzed, yielding 257,963 person-years of follow-up and 3,154 incident dementia cases. Bayesian generalized linear mixed regression models indicated that frailty trajectories accelerated 4 to 9 years prior to dementia onset, with frailty positively correlated with dementia risk (adjusted hazard ratio, 1.18-1.73). This association remained significant even for participants whose frailty assessments occurred well before dementia diagnosis.

Source:

Ward DD, et al. (2024, November 11). JAMA Neurol. Frailty Trajectories Preceding Dementia in the US and UK. https://pubmed.ncbi.nlm.nih.gov/39527039/