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Published online before print June 7, 2007, 10.1097/psy.0b013e318068de1d
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Psychosomatic Medicine 69:483-489 (2007)
© 2007 American Psychosomatic Society

ORIGINAL ARTICLES

Frailty is Associated With Incident Alzheimer’s Disease and Cognitive Decline in the Elderly

Aron S. Buchman, MD, Patricia A. Boyle, PhD, Robert S. Wilson, PhD, Yuxiao Tang, PhD and David A. Bennett, MD

From the Rush Alzheimer’s Disease Center (A.S.B., P.A.B., R.S.W., D.A.B.), Rush University Medical Center; Department of Neurological Sciences (A.S.B., R.S.W., D.A.B.), Rush University Medical Center; Department of Behavioral Science (P.A.B., R.S.W.), Rush University Medical Center; Rush Institute for Healthy Aging and Department of Internal Medicine (Y.T.), Rush University Medical Center, Chicago, Illinois.

Address correspondence and reprint requests to Aron S. Buchman, Rush Alzheimer’s Disease Center; Rush University Medical Center; Armour Academic Facility, Suite #1038; 600 South Paulina Street, Chicago, IL 60612. E-mail: Aron_S_Buchman{at}rush.edu

Objective: To assess the association between frailty and incident Alzheimer’s disease (AD) and cognitive decline. Frailty is common in older persons and associated with adverse health outcomes.

Methods: Study subjects included 823 older persons without dementia who participated in the Rush Memory and Aging Project, a longitudinal study of aging, and underwent annual assessments of frailty, cognition, and diagnostic evaluation for AD.

Results: During a 3-year follow-up, 89 of 823 participants developed AD. In a proportional hazards model, both baseline level of frailty and annual rate of change in frailty were associated with an increased risk of incident AD. Each additional one tenth of a unit increase on the frailty scale at baseline was associated with >9% increased risk of AD (hazard ratio: 2.44; 95% confidence interval (CI): 1.49, 3.37); each one tenth of a unit increase in annual rate of change in frailty was associated with a 12% increased risk of AD (hazard ratio: 3.30; 95% CI: 1.52, 7.13). These results were unchanged in analyses controlling for vascular risk factors and vascular diseases. Results were similar with a categorical measure of frailty instead of a continuous measure. Further, linear mixed-effects models showed that the level of and rate of change in frailty were also associated with the rate of cognitive decline.

Conclusion: Increasing frailty is associated with incident AD and the rate of cognitive decline in older persons. These findings suggest that frailty and AD may share similar etiologies.

Key Words: aging • frailty • cognitive decline • Alzheimer's disease • dementia

Abbreviations: AD = Alzheimer’s disease; PD = Parkinson’s disease; CI = confidence interval; BMI = body mass index; SD = standard deviation.






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