Reducing frailty could reduce dementia risk, study finds

Reducing frailty in older adults could be an effective strategy to prevent dementia, according to a large-scale, international study.

Published in the Journal of Neurology, Neurosurgery and Psychiatry, the study found that frailty was a strong risk factor for dementia, even among people who are at a high genetic risk for dementia, and that it might be modified through a healthy lifestyle.

The researchers from Dalhousie University and Nova Scotia Health in Canada and the University of Exeter in the UK, examined data from more than 196,000 adults aged over 60 in the UK Biobank.

They calculated participants’ genetic risk and used a previously-developed score for frailty. They then analysed this alongside a score on healthy lifestyle behaviours, and who went on to develop dementia.

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Over the 10-year study period, dementia was detected via hospital admission records in 1,762 of the participants – and these people were much more likely to have a high degree of frailty before their diagnosis than those who did not develop dementia.

The risk of dementia was more than 2.5 times higher among study participants who had a high degree of frailty, even after controlling for numerous genetic determinants of dementia, the researchers found.

In those at the highest genetic risk of dementia, the researchers found that risk was lowest in people who were fit, and highest in people who were in poor health.

However, the combination of high genetic risk and high frailty was found to be particularly detrimental, with participants at six times greater risk of dementia than participants without either risk factor.

‘Meaningful action’

Lead author Dr David Ward, from the division of geriatric medicine at Dalhousie University, said they are seeing "increasing evidence that taking meaningful action during life can significantly reduce dementia risk".

Prof Rose Anne Kenny, who teaches medical gerontology at Trinity College Dublin, and is the lead investigator of the longitudenal study on ageing in Ireland, said it has been known that there is a link between frailty and dementia.

“What hasn’t been clear was whether frailty can result in new onset dementia. What this study shows ... is having frailty, whether or not you have the gene, can significantly increase your likelihood of getting dementia. That’s new,” she added.

Prof Kenny said people over 50 should increase their activity levels, with over 70s increasing activity further again, rather than slowing down at these ages, to reduce this risk.

Susan O’Carroll, chartered physiotherapist, and the senior physiotherapist on the frailty intervention therapy team at University Hospital Kerry, said frailty is a geriatric syndrome.

In the over 55s, about 9 or 10 per cent have frailty, but in the over 70s this can rise to about 20 to 25 per cent, she said.

“There are some things we can’t change, such as genetics. But there are lots of things we can so and most of it is adopting a healthy lifestyle,” she said.

“Nothing anything out of the ordinary, but just a healthy diet, making sure we’re not underweight or overweight, and that we’re getting our activity in, both aerobic and resistance training.”