College of Medical, Veterinary & Life Sciences

Early detection and treatment of frailty and pre-frailty, may help to reduce the risk of dementia, or delay its onset.

New research, led by the University of Glasgow and published today in The Lancet Healthy Longevity, which analysed dementia data in UK Biobank, has found that frailty and pre-frailty accounted for almost 20% of dementia cases.

As frailty may be preventable in many cases, researchers say that this new data suggests that early detection and treatment of this condition may in turn reduce the dementia burden attributable to frailty.

In the UK, more than 850,000 people have dementia, while globally that figure is currently approximately 50 million. By 2050 however, scientists estimate that 152 million people worldwide will have dementia as populations grow older. However, recent reports have suggested that up to 40% of dementia cases could be prevented or delayed, with frailty highlighted as a risk factor.

This new Lancet study analysed the data from 143,215 UK Biobank participants, of which 68,500 (47·8%) were pre-frail and 5,565 (3·9%) were frail. During a median follow-up period of 5·4 years, 726 of these individuals developed dementia. Researchers concluded that compared with non-frail individuals, the risk of dementia incidence was increased by 20% for individuals with pre-frailty and almost doubled for those with frailty.

The research also found a link between frailty in younger patients and a risk of dementia. Individuals with frailty aged younger than 60 years old had an increased risk of dementia compared with those who were older. The study also found that individuals with frailty are likely to experience dementia 3·58 years earlier than non-frail individuals.

Of the five components used to define frailty, four of them (weight loss, tiredness, low grip strength and slow gait speed) were all independently associated with increased dementia risk. Among these frailty components, individuals with slow gait have the largest increased risk of dementia.

Dr Carlos Celis-Morales, lead author of the study from the University of Glasgow, said: “Given that currently available medicines can neither cure nor reverse dementia, and offer little symptom relief, there is an urgent need to identify potential risk factors that could prevent or slow development of this terrible disease.

“This study further exposes the link between pre frailty and frailty and the risk of dementia, and highlights the importance, moving forward, of early identification and treatment of patients with frailty. Public strategies aiming to improve physical capabilities, especially those related to muscle strength in middle-aged and older adults, might contribute to reducing the burden of frailty and, as a consequence, reduce the dementia risk attributable to frailty.”

Based on population attributable analyses, in this UK Biobank study sample, pre-frailty and frailty accounted for 9·9% and 8·6% of dementia cases, respectively.

Fanny Petermann-Rocha, the first author of this study said: “Frailty, described as a state of increased vulnerability to adverse health outcomes, is an increasing medical problem around the world as populations get older. However, more recently, researchers have highlighted that frailty can be found in middle age populations, particularly in those who have underlying health conditions.”

The study, ‘Associations between physical frailty and dementia incidence: a prospective study from UK Biobank’ is published in The Lancet Healthy Longevity.

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First published: 2 November 2020