Premium
O4‐06‐02: Frailty is Associated with Subjective Cognitive Decline in Older Female Adults without Dementia: The Vanderbilt Memory & Aging Project
Author(s) -
Bell Susan,
Liu Dandan,
Neal Jacquelyn E.,
Gifford Katherine A.,
Hohman Timothy J.,
Jefferson Angela L.
Publication year - 2016
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.2016.06.638
Subject(s) - grip strength , medicine , dementia , cognitive decline , cognition , cohort , physical therapy , effects of sleep deprivation on cognitive performance , physical medicine and rehabilitation , gait , preferred walking speed , disease , psychiatry
Background:Subjective cognitive decline (SCD) predicts cognitive progression and diagnostic conversion and may represent early changes across the cognitive spectrum. Physical frailty represents a loss of physiological reserve and is associated with cognitive impairment and incident dementia. We hypothesized that early frailty markers are associated with increased SCD.Methods:Participants with normal cognition (n1⁄4164, 60% male) and mild cognitive impairment (n1⁄4165, 59% male) were drawn from the Vanderbilt Memory & Aging Project, a case-control cohort. Markers of frailty (gait speed, grip strength, exhaustion, physical activity) were measured using standard methods and a composite frailty score was calculated by averaging the individual component z-scores. SCD was quantified using a multi-questionnaire protocol, including a total SCD inventory and the Everyday Cognition Scale (ECog). Proportional odds models, stratified by sex, related gait speed, grip strength, and composite frailty score to total SCD score and total ECog scale adjusting for age, education, body mass index, cognitive diagnosis, depression, Framingham Stroke Risk Profile (including age, sex, systolic blood pressure, anti-hypertensive medication usage, diabetes, left ventricular hypertrophy, atrial fibrillation, and prevalent cardiovascular disease), and height (in gait speed models only). Results: Mean age of participants was 7367 years; gait speed was 1.1160.22 m/sec; grip strength was 31611 kg; and total SCD score was 297697. 46% of women and 32% of men were categorized as pre-frail using standard criteria. Using a false discovery rate of 0.1 for multiple comparisons, gait speed, grip strength and composite frailty were not associated with total SCD in men. In comparison, increasing gait speed was associated with lower total SCD (OR1⁄40.09, 95%CI 0.01-0.75, p1⁄40.025) and total ECog score (OR1⁄40.07, 95%CI 0.01-0.44, p1⁄40.0049). Increasing composite frailty was associated only with the total ECog score (OR1⁄42.01, 95%CI 1.05-3.85, p1⁄40.0365). Conclusions:Among older women without dementia, early markers of frailty (gait speed, composite frailty score) are associated with more SCD. Findings suggest frailty (an independent predictor of the development and progression of cognitive impairment) is related to other early markers of dementia. Further studies should investigate underlying mechanisms linking early changes in frailty, SCD, and cognition.