Association Between Frailty and Carotid Central Structure Changes: The Three-City Study.

Objectives To demonstrate the association between carotid central structure changes and frailty. Design Cross-sectional study. Setting The Three-City Study, a French prospective cohort designed to evaluate the risk of cognitive decline attributable to vascular risk factors. Participants Community-dwelling individuals aged 65 to 95 (N = 4,257). Measurements Frailty was defined as proposed by Fried and colleagues. Carotid intima-media thickness ( IMT), diameter of the common carotid arteries, and the presence of plaques in both carotid arteries were determined using carotid Doppler ultrasonography. Multinomial logistic regression models, including adjustment for traditional cardiovascular and dementia risk factors, were used to evaluate the independent association between the central arterial structure and frailty. Results 6.8% of participants were classified as frail. Multivariate regression models showed an independent association between carotid IMT and frailty and between carotid diameter and frailty after adjusting for sociodemographic factors, cardiovascular risk factors, disability, and apolipoprotein E ε4 genotype. A 1-standard deviation ( SD) increase in IMT (odds ratio ( OR) = 1.15; P = .04) and a 1- SD increase in carotid diameter ( OR = 1.23; P = .006) were associated with greater probability of being frail. Conclusion The association between carotid structure changes and frailty suggests that frail elderly adults have vascular damage, which may explain, at least partly, why several adverse health-related outcomes are frequently observed in frail elderly adults. [ABSTRACT FROM AUTHOR]