Key points
- Frailty has been linked to earlier dementia diagnosis by 2-3 years.
- Frailty may predict dementia before other signs appear.
- Exercise, diet and social activity can reduce frailty.
Being frail appears to accelerate the onset of dementia, particularly in people who show little or no signs of the disease, a University of Queensland-led study has found.
Dr David Ward from UQ's Frazer Institute said the findings suggest frailty could be an important independent clinical marker to help diagnose and potentially treat dementia.
"Frailty has traditionally been linked to neurodegenerative conditions like dementia, but instead of just being a consequence of ageing or declining health, it appears to play its own role in shaping how dementia develops and is diagnosed," Dr Ward said.
"Our findings show older adults living with frailty are diagnosed with dementia 2 to 3 years earlier than those who are less frail.
"Importantly, people who were considered frail but did not have the usual brain abnormalities associated with dementia developed the condition 5 to 6 years earlier."
The findings do not only position frailty as an early marker for dementia risk, but managing frailty may help delay the onset of dementia.
"The encouraging message is that frailty is often preventable and treatable," Dr Ward said.
"Regular exercise-especially strength training-can delay, reduce, and in some cases improve frailty, particularly when combined with good nutrition and social engagement.
"If clinicians routinely measure and monitor frailty, there may be opportunities to delay dementia progression and improve outcomes."
The study analysed longitudinal data from more than 1,600 participants in the Memory and Aging Project coordinated by Rush University in the United States over 24 years.
Researchers found the link between frailty and earlier dementia diagnosis was consistent across all groups studied, although the effect appeared stronger in men.
Study co-author Tom Strating, a medical student at Maastricht University in the Netherlands, said genetic markers did not influence the findings.
"A gene variant called APOE ε4 is associated with a higher risk of developing Alzheimer's disease, but frailty affected carriers and non-carriers in the same way," Mr Strating said.
"People with fewer dementia-related brain changes would usually be expected to develop dementia later.
"However, this benefit significantly reduced in people with frailty, who developed dementia at a similar age to those with more brain changes.
"Only people with low levels of frailty appeared to gain the protective benefit of having fewer brain changes."
Read the research in Journal of Neurology, Neurosurgery and Psychiatry.
Collaboration and acknowledgements
This study was led by researchers from the Frazer Institute at The University of Queensland and involved collaborations with the UQ Clinical Trials Capability (ULTRA) Team, the Australian Frailty Network, Maastricht University (the Netherlands), the University of Oulu (Finland) and Dalhousie University (Canada).
