Abstract
BackgroundFrailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a dementia risk syndrome characterized by later-life emergence of persistent neuropsychiatric symptoms, has yet to be elucidated. We aimed to evaluate the associations between MBI and frailty in older adults without dementia.MethodsIn this cross-sectional study, a consecutive series of 137 older adults without dementia in the Anti-Aging Study, recruited from primary care clinics, were enrolled. Frailty was estimated using the Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist (MBI-C) at a cut-off point of > 8. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariable logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.ResultsAt baseline, 30.7% of the older adults had frailty and 18.2% had MBI (MBI+ status). Multivariable logistic regression analysis demonstrated that compared to those without MBI (MBI- status), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, 95% CI = 1.49–37.21, p = 0.02). Frailty and MBI were both significantly associated with both MMSE and MoCA-BC score (p < 0.05).ConclusionsBoth frailty and MBI status were associated with higher odds of cognitive impairment. MBI was significantly associated with an increased risk of having frailty in the absence of dementia. This association merits further study to identify potential strategies for the early detection, prevention and therapeutic intervention of frailty.
Highlights
Frailty and cognitive decline are highly prevalent among older adults
Frailty moderates the association between Alzheimer’s disease (AD) pathology and the clinical expression of dementia, such that in the presence of frailty, even low AD pathological burden may manifest as dementia [17]
mild behavioral impairment (MBI) has been used in machine learning models to predict neurocognitive diagnostic category 40 months later [36]. These findings suggested that the early recognition of the neuropsychiatric symptoms (NPS) that constitute MBI may contribute to earlier detection of neurodegeneration, and may represent a clinical entity and premorbid treatment target to explore for intervention strategies to prevent or delay the onset of dementia [37]
Summary
Frailty and cognitive decline are highly prevalent among older adults. Frailty is a common geriatric condition presenting as a clinical state of decreased physiological reserve, increased vulnerability to death and increased susceptibility to even small stressors [1]. It is associated with an increased risk of adverse health-related outcomes, Fan et al BMC Geriatrics (2020) 20:510 phenotypic approach or a deficit accumulation approach [5, 6]. Cognitive impairment has been shown to improve the predictive value of frailty, measured using the Fried phenotype, for adverse health outcomes [11]. Associations between frailty and other risk markers for cognitive decline are warranted
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