Reduce Frailty to Reduce the Risk of Dementia

According to a large-scale new study, reducing frailty in older adults could be an effective strategy for preventing dementia. Dementia and frailty both have a significant impact on individuals, families, and society. Several studies have found that frailty is linked to an increased risk of dementia.

The study, which was published in the Journal of Neurology, Neurosurgery, and Psychiatry, discovered that frailty was a strong risk factor for dementia, even among people who had a high genetic risk for dementia, and that it could be modified by leading a healthy lifestyle.

The international team from Dalhousie University and Nova Scotia Health in Canada, as well as the University of Exeter in the United Kingdom, worked with data from the UK Biobank, which included more than 196,000 adults over the age of 60. They calculated the genetic risk of participants and used a previously developed frailty score, which reflects the accumulation of age-related symptoms, signs, disabilities, and diseases. They looked at this in conjunction with a score on healthy lifestyle behaviors and who went on to develop dementia.

Our findings are a significant step forward in understanding how reducing frailty can significantly improve a person’s chances of avoiding dementia, regardless of genetic predisposition to the condition. This is exciting because we believe that some of the underlying causes of frailty can be avoided.

Dr. David Ward

“We’re seeing more evidence that taking meaningful action during life can significantly reduce dementia risk,” says lead author Dr. David Ward of Dalhousie University’s Division of Geriatric Medicine. “Our findings are a significant step forward in understanding how reducing frailty can significantly improve a person’s chances of avoiding dementia, regardless of genetic predisposition to the condition. This is exciting because we believe that some of the underlying causes of frailty can be avoided. This appeared to be possible in our study, in part, by engaging in healthy lifestyle behaviors.”

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

The researchers examined the impact of genetic risk in people with varying degrees of frailty, emphasizing the importance of preventing or reducing frailty. Genetic risk factors had the expected effect on dementia risk in healthy study participants, but genes became less important in the most frail study participants. The risk of dementia was high in those frail study participants, regardless of their genes.

Reduce frailty to lower dementia

Even in those with the highest genetic risk of dementia, the researchers discovered that risk was lowest in fit people and highest in people in poor health, as measured by a high degree of frailty. However, the combination of high genetic risk and frailty was found to be especially harmful, with participants six times more likely to develop dementia than those who did not have either risk factor.

Even after controlling for numerous genetic determinants of dementia, the risk of dementia was more than 2.5 times higher (268%) among study participants with a high degree of frailty compared to those with a low degree of frailty.

The study identified pathways for lowering the risk of dementia. Participants in the study who reported higher levels of engagement in healthy lifestyle behaviors were less likely to develop dementia, possibly due to a lower level of frailty.

“The risk of dementia reflects genetic, neuropathological, lifestyle, and general health factors, which in turn give rise to a range of abnormalities in the brain,” says Dr. Kenneth Rockwood, a Professor of Geriatric Medicine and Neurology at Dalhousie University and the Senior Medical Director of Nova Scotia Health’s newly formed Frailty and Elder Care Network.

“Our research represents an important step forward in understanding the role of frailty, which appears to have a distinct and potentially modifiable pathway in influencing dementia risk. That’s an incredibly exciting prospect that we must urgently explore to potentially benefit the growing number of people worldwide affected by dementia.”

Dr. Janice Ranson of the University of Exeter Medical School, one of the study’s co-authors, stated: “These findings have extremely positive implications, demonstrating that dementia is not unavoidable, even if you have a genetic predisposition. We can take meaningful steps to reduce our risk; addressing frailty could be an effective strategy for maintaining brain health while also assisting people in remaining mobile and independent in later life.”