TOPLINE:

Both frailty and pre-frailty, a transitional stage often considered to be reversible with interventions, were associated with a significantly faster decline in global and domain cognition among older adults than among robust individuals, new research showed. Significant associations were also found between frailty and declining memory, orientation, and executive function.

METHODOLOGY:

• The analysis included data for nearly 50,000 participants (mean age, 62 years; 53% women) from three prospective cohorts: the China Health and Retirement Longitudinal Study, Health and Retirement Study, and English Longitudinal Study of Ageing. Follow-up durations for the studies were 2.9, 8.4, and 3.2 years, respectively.
• Degree of frailty was assessed using a frailty index based on 28 age-related health deficits. 50% of the participants were categorized as robust, 32% as pre-frail, and 18% as frail.
• Cognitive function was evaluated by assessing memory, orientation, and executive function. Covariates included age, sex, education, marital status, smoking status, drinking status, BMI, and time.

TAKEAWAY:

• Participants with pre-frailty and frailty had significantly accelerated declines of 0.11 SD/year and 0.29 SD/year, respectively, in global cognitive z-scores compared with robust participants (P for trend < .0001).
• Those with pre-frailty and frailty also showed declined z-scores for memory (beta, -0.11 and -0.27, respectively), orientation (beta, -0.06 and -0.15), and executive function (beta, -0.08 and -0.21).
• Sensitivity analyses showed a stronger association between frailty and global cognitive decline (beta, -0.36) and memory decline (beta, -0.37) for participants aged 60 years or older.
• The use of “raw cognitive scores” in place of z-scores showed findings consistent with the primary analysis. Compared to robustness, the mean difference in rate of change for global cognition scores were -0.55 for pre-frailty and -1.45 for frailty (P < .001 for both).

IN PRACTICE:

“Pre-frailty and frailty are associated with an increased risk of cognitive impairment, highlighting the need for early assessment and monitoring of frailty in at-risk populations,” the investigators wrote. 

“Future research should develop targeted interventions to monitor the trajectory of frailty and timely implement strategies to prevent cognitive impairment in older adults,” they added.

SOURCE:

The study was led by Xiangyu Zhang, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, China. It was published online on November 18 in Translational Psychiatry.

LIMITATIONS:

The observational nature of the study limited establishing direct causality between frailty and cognitive function. The frailty index was developed using only 28 deficits, whereas including at least 30-40 deficits is recommended by classic frailty theory. Residual confounding factors may have influenced the study results.

DISCLOSURES:

The study was funded by the Major Projects of Collaborative Innovation of Zhengzhou, Special Major Public Welfare Project of Henan Province, Key project of Science and Technology of Henan Province, and key R&D program of Henan province. The investigators reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.