Advertisement

The journal of nutrition, health & aging

, Volume 21, Issue 6, pp 648–654 | Cite as

Frailty in relation to the risk of Alzheimer’s disease, dementia, and death in older Chinese adults: A seven-year prospective study

  • C. Wang
  • X. Ji
  • X. Wu
  • Z. Tang
  • X. Zhang
  • S. Guan
  • H. Liu
  • Xianghua FangEmail author
Article

Abstract

Objectives

To explore the relationship of general health decline assessed by frailty and risk of dementia and Alzheimer’s disease (AD).

Design

A seven-year prospective cohort study.

Setting

Secondary analysis of data from the Beijing Longitudinal Study on Aging.

Participants

Urban and rural communitydwelling people aged 60 and older at baseline.

Measurements

Frailty was quantified using the deficit accumulation-based frailty index (FI), constructed from 40 health deficits at baseline. Dementia was diagnosed by DSM-IIIR. AD and vascular dementia (VaD) were diagnosed by NINCDS-ADRDA and NINDS-AIREN. The relationships between frailty and the risk of dementia, AD and death were evaluated through multivariable models.

Results

Of 2788 participants at baseline (1997), 171 (11.1%) reported a history of dementia. In seven years, 351 people developed dementia (13%: 223 AD and 128 other types of dementia) and 813 died (29%). After adjustment for age, sex, education, and baseline cognition, baseline frailty status significantly associated with Alzheimer’s disease and dementia and death. For each deficit accumulated, the odds ratio of death increased by 5.7%, and the odds ratio of dementia increased by 2.9% (p < 0.001).

Conclusion

Frailty was associated with Alzheimer’s disease and dementia over a seven years period. Frailty index might facilitate the identification of older adults at high risk of dementia for the application of the most effective, targeted prevention strategies.

Key words

Ageing frailty frailty index (FI) Alzheimer’s disease (AD) dementia 

References

  1. 1.
    Ballard C, Gauthier S, Corbett A, Brayne C, Aarsland D, Jones E. Alzheimer’s disease. Lancet 2001;377: 1019–1031.CrossRefGoogle Scholar
  2. 2.
    Logsdon RG, Teri L, McCurry SM, Gibbons LE, Kukull WA, Larson EB. Wandering: a significant problem among community-residing individuals with Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci 1998;53(5): 294–299.CrossRefGoogle Scholar
  3. 3.
    Taylor DJ, Schenkman M, Zhou J, Sloan FA. The relative effect of Alzheimer’s disease and related dementias, disability, and comorbidities on cost of care for elderly persons. J Gerontol B Psychol Sci Soc Sci 2001;56(5): 285–293.CrossRefGoogle Scholar
  4. 4.
    Zhang ZX, Zahner GE, Roman GC, et al. Socio-demographic variation of dementia subtypes in china: Methodology and results of a prevalence study in Beijing, Chengdu, Shanghai, and Xian. Neuroepidemiology 2006;177–187.Google Scholar
  5. 5.
    Zhang ZX, Zahner GE, Roman GC et al. Dementia subtypes in China: prevalence in Beijing, Xian, Shanghai, and Chengdu. Arch Neurol 2005;62(3): 447–453.CrossRefPubMedGoogle Scholar
  6. 6.
    Berti V, Murray J, Davies M, Spector N, Tsui WH, Li Y, Williams S, Pirraglia E, Vallabhajosula S, McHugh P, Pupi A, de Leon MJ, Mosconi L. Nutrient patterns and brain biomarkers of Alzheimer’s disease in cognitively normal individuals. J Nutr Health Aging. 2015;19(4): 413–423.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Krause D, Roupas P. Effect of Vitamin Intake on Cognitive Decline in Older Adults: Evaluation of the Evidence. J Nutr Health Aging. 2015;19(7): 745–753.CrossRefPubMedGoogle Scholar
  8. 8.
    Handing EP, Small BJ, Reynolds SL, Kumar NB. Impact of dietary factors and inflammation on cognition among older adults. J Prev Alz Dis. 2015; 2(4):220–226.Google Scholar
  9. 9.
    Willey JZ, Gardener H, Caunca MR et al. Leisure-time physical activity associates with cognitive decline: The Northern Manhattan Study. Neurology, 2016. pii: 10.1212/WNL.0000000000002582. [Epub ahead of print]Google Scholar
  10. 10.
    Fried LP, Tangen CM, Walston J et al. Frailty in older adults:evidence for a phenotype. Journal of Gerontology:Medical Sciences 2001;56A:M146–M156.Google Scholar
  11. 11.
    Rockwood K, Mitnitski A, MacKnight C. Some mathematical models of frailty and their clinical implications. Rev Clin Gerontol 2002;12: 109–117.CrossRefGoogle Scholar
  12. 12.
    Mitnitski AB, Mogilner AJ, Rockwood K. Accumulation of deficits as a proxy measure of aging. Scientific World Journal 2001;1: 323–336CrossRefPubMedGoogle Scholar
  13. 13.
    Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K. A standard procedure for creating a frailty index. BMC Geriatr 2008; 8:24CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Rockwood K, Mitnitski A, Song X, Steen B, Skoog I. Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc 2006;54(6): 975–979.CrossRefPubMedGoogle Scholar
  15. 15.
    Rockwood K, Song X, MacKnight C et al. A global clinical measure of fitness and frailty in elderly people. CMAJ 2005;173(5): 489–495.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Mitnitski A, Song X, Rockwood K. Assessing biological aging: the origin of deficit accumulation. Biogerontology 2013;14(6): 709–717.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Goggins WB, Woo J, Sham A, Ho SC. Frailty index as a measure of biological age in a Chinese population. J Gerontol A Biol Sci Med Sci 2005;60(8): 1046–1051.CrossRefPubMedGoogle Scholar
  18. 18.
    Gu D, Dupre ME, Sautter J, Zhu H, Liu Y, Yi Z. Frailty and mortality among Chinese at advanced ages. J Gerontol B Psychol Sci Soc Sci 2009;64(2): 279–289.CrossRefPubMedGoogle Scholar
  19. 19.
    Mitnitski AB, Song X, Rockwood K. The estimation of relative fitness and frailty in community-dwelling older adults using self-report data. J Gerontol A Biol Sci Med Sci 2004;59(6):M627–632.CrossRefPubMedGoogle Scholar
  20. 20.
    Hubbard RE, Lang IA, Llewellyn DJ, Rockwood K. Frailty, body mass index, and abdominal obesity in older people. J Gerontol A Biol Sci Med Sci 2010;65(4): 377–381.CrossRefPubMedGoogle Scholar
  21. 21.
    Kelaiditi E, Andrieu S, Cantet C, Vellas B, Cesari M; ICTUS/DSA Group. Frailty Index and Incident Mortality, Hospitalization,and Institutionalization in Alzheimer’s Disease: Data From the ICTUS Study. J Gerontol A Biol Sci Med Sci, 2015. pii: glv137. [Epub ahead of print].Google Scholar
  22. 22.
    Tang Z, Wang C, Song X et al. Co-occurrence of cardiometabolic diseases and frailty in older Chinese adults in the Beijing Longitudinal Study of Ageing. Age Ageing 2013;42(3): 346–351.CrossRefPubMedGoogle Scholar
  23. 23.
    Wang C, Song X, Mitnitski A et al. Effect of health protective factors on health deficit accumulation and mortality risk in older adults in the Beijing Longitudinal Study of Aging. J Am Geriatr Soc 2014;62(5): 821–828.CrossRefPubMedGoogle Scholar
  24. 24.
    Wang C, Song X, Mitnitski A et al. Gender differences in the relationship between smoking and frailty: results from the Beijing Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 2013;68(3): 338–346.CrossRefPubMedGoogle Scholar
  25. 25.
    Shi J, Song X, Yu P et al. Analysis of frailty and survival from late middle age in the Beijing Longitudinal Study of Aging. BMC Geriatr 2011;11:17.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Yu P, Song X, Shi J et al. Frailty and survival of older Chinese adults in urban and rural areas: results from the Beijing Longitudinal Study of Aging. Arch Gerontol Geriatr 2012;54(1): 3–8.CrossRefPubMedGoogle Scholar
  27. 27.
    Auyeung TW, Lee JS, Kwok T, Woo J. Physical frailty predicts future cognitive decline -a four-year prospective study in 2737 cognitively normal older adults. J Nutr Health Aging 2011;15(8): 690–694.CrossRefPubMedGoogle Scholar
  28. 28.
    Boyle PA, Wilson RS, Buchman AS et al. Lower extremity motor function and disability in mild cognitive impairment. Exp Aging Res. 2007;33(3): 355–371.CrossRefPubMedGoogle Scholar
  29. 29.
    Song X, Mitnitski A, Rockwood K. Nontraditional risk factors combine to predict Alzheimer disease and dementia. Neurology 2011;77(3): 227–234.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Song X, Mitnitski A, Rockwood K. Age-related deficit accumulation and the risk of late-life dementia. Alzheimers Res Ther 2014;6(5-8):54.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Jiang J, Tang Z, Meng XJ, Futatsuka M. Demographic determinants for change in activities of daily living: a cohort study of the elderly people in Beijing. J Epidemiol 2002;12(3): 280–286.CrossRefPubMedGoogle Scholar
  32. 32.
    Tang Z, Wang HX, Meng C et al. The prevalence of functional disability in activities of daily living and instrumental activities of daily living among elderly Beijing Chinese. Arch Gerontol Geriatr 1999;29(2): 115–125.CrossRefPubMedGoogle Scholar
  33. 33.
    Shi J, Yang Z, Song X et al. Sex differences in the limit to deficit accumulation in late middle-aged and older Chinese people: results from the Beijing Longitudinal Study of Aging. J Gerontol A Biol Sci Med Sci 2014;69(6): 702–709.CrossRefPubMedGoogle Scholar
  34. 34.
    Ebly EM, Hogan DB, Rockwood K. Living alone with dementia. Dement Geriatr Cogn Disord 1999;10(6): 541–548.CrossRefPubMedGoogle Scholar
  35. 35.
    Tuokko H, MacCourt P, Heath Y. Home alone with dementia. Aging Ment Health 1999;3(1): 21–27.CrossRefGoogle Scholar
  36. 36.
    Lehmann SW, Black BS, Shore A, Kasper J, Rabins PV. Living alone with dementia: lack of awareness adds to functional and cognitive vulnerabilities. Int Psychogeriatr 2010;22(5): 778–784.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Buchman AS, Boyle PA, Wilson RS, Tang Y, Bennett DA. Frailty is associated with incident Alzheimer’s disease and cognitive decline in the elderly. Psychosom Med 2007;69: 483–489.CrossRefPubMedGoogle Scholar
  38. 38.
    Stephan BC, Kurth T, Matthews FE, Brayne C, Dufouil C. Dementia risk prediction in the population: are screening models accurate? Nat Rev Neurol 2010;6: 318–326.CrossRefPubMedGoogle Scholar
  39. 39.
    Kulmala J, Nykanen I, Manty M, Hartikainen S. Association between frailty and dementia: a population-based study. Gerontology 2014;60(1): 16–21.CrossRefPubMedGoogle Scholar
  40. 40.
    Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56(3):M146–156.CrossRefPubMedGoogle Scholar
  41. 41.
    Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59(3): 255–263.CrossRefPubMedGoogle Scholar

Copyright information

© Serdi and Springer-Verlag France 2017

Authors and Affiliations

  • C. Wang
    • 1
  • X. Ji
    • 2
  • X. Wu
    • 1
  • Z. Tang
    • 1
  • X. Zhang
    • 3
  • S. Guan
    • 1
  • H. Liu
    • 1
  • Xianghua Fang
    • 1
    Email author
  1. 1.Department of Evidence-based Medicine, Xuanwu HospitalCapital Medical UniversityBeijingChina
  2. 2.Department of Neurological Surgery, Xuanwu HospitalCapital Medical UniversityBeijingChina
  3. 3.Department of Neurology, Xuanwu HospitalCapital Medical UniversityBeijingChina

Personalised recommendations