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P3‐074: Frailty as a risk for the development and progression of cognitive impairment in older adults: Results of a dynamic model
Author(s) -
Mitnitski Arnold B.,
Fallah Nader,
Rockwood Kenneth
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.1568
Subject(s) - cognition , gerontology , logistic regression , cognitive decline , frailty index , medicine , operationalization , effects of sleep deprivation on cognitive performance , psychology , demography , dementia , psychiatry , disease , philosophy , epistemology , sociology
However, to date there has been little work investigating whether poorer performance on functional biomarkers predicts the subsequent development of dementia, or preclinical dementia syndromes. Methods: 2082 individuals, aged 60-64 years and participating in a prospective epidemiological study of mental health and aging were assessed at two time-points four years apart for mild cognitive impairment (MCI), or any of a suite of criteria sets for mild cognitive disorders (any-MCD). Logistic regression was used to assess whether functional biomarkers (grip, lung capacity, vision, blood pressure, pegboard) predicted conversion over four years from normal aging to diagnosis in those without diagnosis at baseline. All analyses were adjusted for age, sex, education and height. Results: 2018 participants were classified as normal, 64 with Any-MCD of which 18 were diagnosed with MCI. Baseline lung function, grip, visual acuity and blood pressure did not predict conversion to any-MCD. Baseline performance on the pegboard was predictive of conversion p< .01. Decline in lung function and decline in performance on Pegboard were associated with conversion to MCI, any-MCD (all p < .01). Conclusions: In the young-old, decline in lung function and a measure of fine motor dexterity were associated with transition from normal ageing to pre-clinical dementia. Performance on the pegboard involves integration of processing speed with visual acuity, and grip strength and hence may be a more refined measure of subtle changes in functional capacity than performance on single tests of individual sensory or motor functions making it more sensitive to concomitant cognitive decline. The link between problems in IADLs and the progression of MCI may be due to subtle sensorimotor changes indexed by functional biomarkers. We conclude that broader transitions in functional age are associated with dementia risk and that further investigation of this relationship may assist in defining the decline in IADLs that occurs in MCI and dementia.