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Frailty Could Increase Susceptibility for Dementia

FRIDAY, Jan. 18, 2019 — Frailty and Alzheimer disease-related brain changes independently contribute to dementia status, according to a study published in the February issue of The Lancet Neurology.

Lindsay M.K. Wallace, from the Nova Scotia Health Authority in Halifax, Canada, and colleagues used data from the Rush Memory and Aging Project to evaluate the association between frailty, neuropathology, and dementia in Alzheimer disease. Included participants (456) either did not have any form of dementia or had possible or probable Alzheimer dementia at the time of their last clinical assessment (53 percent) and subsequently died but had complete autopsy data available.

The researchers found that frailty (odds ratio, 1.76) and Alzheimer disease pathology (odds ratio, 4.81) were independently associated with Alzheimer dementia after adjusting for age, sex, and education. There was a significant interaction between frailty and Alzheimer disease pathology (odds ratio, 0.73); people with a higher score for frailty had a weakened direct link between Alzheimer disease pathology and Alzheimer dementia. Specifically, people with a low amount of frailty were better able to tolerate Alzheimer disease pathology, while those with higher frailty were more likely to have both more Alzheimer disease pathology and expression as dementia.

“That frailty is related to both odds of Alzheimer dementia and disease expression has implications for clinical management, since individuals with even a low level of Alzheimer disease pathology might be at risk for dementia if they have high amounts of frailty,” write the authors.

Several authors disclosed financial ties to the pharmaceutical industry.

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Posted: January 2019

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