Summary: Frailty is a strong predictor of dementia risk, with risk increasing by 40% with each 4-5 additional age-related health conditions. This connection between frailty and dementia suggests that frailty may not simply result from undetected dementia but actively contributes to its onset.
Monitoring frailty could be crucial in preventing dementia, as interventions targeting fitness, nutrition, and lifestyle may reduce risks. Researchers propose that routine frailty screening and health programs could help improve long-term cognitive health outcomes. This research could shape future clinical approaches and early interventions to combat dementia.
Key Facts:
- Frailty increases dementia risk by 40% for every 4-5 added health issues.
- Frailty can accelerate as early as 9 years before dementia symptoms appear.
- Integrating frailty screening in regular health checks could aid dementia prevention.
Source: University of Queensland
An international study led by a University of Queensland researcher has found frailty increases a person’s risk of dementia, but early intervention may be the key to prevention.
Dr David Ward from the Centre for Health Services Research tracked the data of nearly 30,000 participants of 4 longitudinal studies in the United Kingdom and the United States, enabling researchers 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 4-5 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.”
Frailty is a health state related to ageing where multiple organ systems lose their resilience, making individuals more likely to experience adverse health outcomes like falls, disability and hospitalisation.
“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.”
According to the World Health Organization more than 55 million people have dementia worldwide, with 10 million new cases every year.
Study co-author, Professor David Llewellyn from the University of Exeter Medical School, said the research was one of the most comprehensive examinations of the link between frailty and dementia.
“This study is crucial because it identifies frailty as a significant predictor of dementia risk, offering a potential pathway for early intervention to improve health outcomes,” Professor Llewellyn said.
“The success of this research hinged on international collaboration, allowing us to investigate different populations and enhance the validity of our findings, which are likely to shape future clinical trials and prevention strategies.”
The study was a collaborative effort between researchers from The University of Queensland, Princess Alexandra Hospital, QIMR Berghofer Medical Research Institute, The University of Edinburgh, Alzheimer Scotland Dementia Research Centre, University of Oxford, University of Cambridge, University of Exeter, Alan Turing Institute, Nova Scotia Health, University of Colorado Boulder, Sapienza University of Rome, Karolinska Institutet, Stockholm University, Italian National Institute of Health, Dalhousie University, and the Medical University of Graz.
Funding: The research was supported by the Deep Dementia Phenotyping (DEMON) Network, and the Australian Frailty Network (AFN).
About this aging and dementia research news
Author: Dea Clark
Source: University of Queensland
Contact: Dea Clark – University of Queensland
Image: The image is credited to Neuroscience News
Original Research: Closed access.
“Frailty Trajectories Preceding Dementia in the US and UK” by David Ward et al. JAMA Neurology
Abstract
Frailty Trajectories Preceding Dementia in the US and UK
Importance
An accessible marker of both biological age and dementia risk is crucial to advancing dementia prevention and treatment strategies. Although frailty is a candidate for that role, the nature of the relationship between frailty and dementia is not well understood.
Objective
To clarify the temporal relationship between frailty and incident dementia by investigating frailty trajectories in the years preceding dementia onset.
Design, Setting, and Participants
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 analyzed from July 2023 to August 2024.
The settings were retirement communities, national-level surveys, and a multiclinic-based cohort. Included individuals were 60 years or older and without cognitive impairment at baseline. Included individuals also had data on age, sex, education level, and ethnicity and a frailty index score calculated at baseline.
Exposure
Frailty was the main exposure, with participants’ degrees of frailty quantified using retrospectively calculated frailty index scores.
Main Outcomes and Measures
Incident all-cause dementia ascertained through physician-derived diagnoses, self- and informant-report, and estimated classifications based on combinations of cognitive tests.
Results
The participant number before exclusions was 87 737. After exclusions, data from 29 849 participants (mean [SD] age, 71.6 [7.7] years; 18 369 female [62%]; 257 963 person-years of follow-up; 3154 cases of incident dementia) were analyzed. Bayesian generalized linear mixed regression models revealed accelerations in frailty trajectories 4 to 9 years before incident dementia.
Overall, frailty was positively associated with dementia risk (adjusted hazard ratios [aHRs] ranged from 1.18; 95% CI, 1.13-1.24 to 1.73; 95% CI, 1.57-1.92). This association held among participants whose time between frailty measurement and incident dementia exceeded the identified acceleration period (aHRs ranged from 1.18; 95% CI, 1.12-1.23 to 1.43; 95% CI, 1.14-1.80).
Conclusions and Relevance
These findings suggest that frailty measurements may be used to identify high-risk population groups for preferential enrolment into clinical trials for dementia prevention and treatment. Frailty itself may represent a useful upstream target for behavioral and societal approaches to dementia prevention.
