Association Between Frailty and Development of Alzheimer's Disease–Related Dementias

Abstract

Frailty is associated with an increased risk for Alzheimer’s disease and related dementias (ADRD). However, this association has not been investigated in older Mexican Americans; a population that is high-risk for frailty and ADRD. This study investigated the association between frailty and the development of ADRD over 9-year period. We analyzed 860 Mexican Americans ≥76 years old of the Hispanic Established Populations for the Epidemiological Study of the Elderly (Hispanic-EPESE) who have been linked with Medicare claims data. Survey data from Wave 6 (2007/08) was used to categorize participants as frail (either pre-frail or frail) or non-frail according to the Fried phenotype. The main outcome was ADRD diagnosis after Wave 6 interview. ADRD status was determined using the Chronic Conditions Segment of the Master Beneficiary Summary File. We estimated ADRD disease-free probability during 2007-2016 using midpoint of interval data method stratified by frailty status. Mean age of the study sample was 83.2 years (SD=4.4) and 59.3% were female. We found individuals who were frail had less ADRD-free months (46.5; SD= 36.5-52) compared to those who were non-frail (66.0; SD= 47.5-120). Individuals with a score of less than 21 points on the Mini Mental Status Exam had greater risks of ADRD development (Odds Ratio=1.35, 95% CI= 1.05-1.74) compared to their counterpart, after controlling mortality as a competing risk. Our results suggest being pre-frail, frail or cognitively impaired are risk factors for ADRD in community-dwelling older Mexican Americans.