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Neuropathologic burden and the degree of frailty in relation to global cognition and dementia
- Source :
- Neurology
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- ObjectiveTo test the hypothesis that degree of frailty and neuropathologic burden independently contribute to global cognition and odds of dementia.MethodsThis was a secondary analysis of a prospective cohort study of older adults living in Illinois. Participants underwent an annual neuropsychological and clinical evaluation. We included 625 participants (mean age 89.7 ± 6.1 years; 67.5% female) who died and underwent autopsy. We quantified neuropathology using an index measure of 10 neuropathologic features: β-amyloid deposition, hippocampal sclerosis, Lewy bodies, tangle density, TDP-43, cerebral amyloid angiopathy, arteriolosclerosis, atherosclerosis, and gross and chronic cerebral infarcts. Clinical consensus determined dementia status, which we coded as no cognitive impairment, mild cognitive impairment, or dementia. A battery of 19 tests spanning multiple domains quantified global cognition. We operationalized frailty using a 41-item frailty index. We employed regression analyses to model relationships between neuropathology, frailty, and dementia.ResultsBoth frailty and a neuropathology index were independently associated with global cognition and dementia status. These results held after controlling for traditional pathologic measures in a sample of participants with Alzheimer clinical syndrome. Frailty improved the fit of the model for dementia status (χ2[2] 72.64; p < 0.0001) and explained an additional 11%–12% of the variance in the outcomes.ConclusionDementia is a multiply determined condition, to which both general health, as captured by frailty, and neuropathology significantly contribute. This integrative view of dementia and health has implications for prevention and therapy; specifically, future research should evaluate frailty as a means of dementia risk reduction.
- Subjects :
- Male
0301 basic medicine
Gerontology
Comorbidity
Neuropathology
Article
03 medical and health sciences
0302 clinical medicine
mental disorders
medicine
Humans
Dementia
Prospective Studies
Prospective cohort study
Aged
Aged, 80 and over
Hippocampal sclerosis
Frailty
business.industry
Neuropsychology
Cognition
medicine.disease
030104 developmental biology
Regression Analysis
Female
Illinois
Neurology (clinical)
Cerebral amyloid angiopathy
Cognition Disorders
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 1526632X and 00283878
- Volume :
- 95
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....76be41efd07ebb2b40e2d5ebf705d45b