Furthermore, the rapid change from robust to frail during a two-year period strongly predicts poor survival over the succeeding two years. The study was funded by the Academy of Finland.
The recent collaborative studies at the University of Jyväskylä and the University of Eastern Finland provide additional evidence that the frailty concept introduced by Fried et al. provides clinically important information about the functional status and survival of older people. The previous results on the association between frailty and memory disorders have been partly inconsistent. The Finnish studies show that physical frailty is strongly associated with cognitive impairment and clinically diagnosed dementia among people aged 76 and older.
“Our study included more than 600 people aged between 76 and 100, and we found that frail people were eight times more likely to have clinically diagnosed dementia, almost six times more likely to have vascular dementia and over four times more likely to have Alzheimer’s disease than those who were robust,” says Postdoctoral Researcher, Dr Jenni Kulmala from the Gerontology Research Center at the University of Jyväskylä.
The association between frailty and a higher mortality risk has been previously acknowledged, but this study provides additional evidence that gender differences in this association should be taken into account. Frailty was strongly associated with higher mortality among women, but among men the found association was explained by baseline functional capacity, comorbidity and lifestyle factors.
“Another interesting finding is the fact that a rapid decline in frailty status during the two-year follow-up period was linked to an eight-fold risk for mortality over the succeeding two years. It seems that a rapid decline in frailty is a better indicator of future adverse events than frailty status measured only once,” Dr Kulmala says.
According to the definition introduced by Linda Fried et al. in 2001, frailty is a clinical syndrome characterised by several physical symptoms, including weight loss, exhaustion, poor hand-grip strength, slow walking speed and physical inactivity. Frailty is associated with physical decline and also with memory problems. The estimated prevalence of frailty in older populations is about 10-20 per cent, with the increasing prevalence rates with increasing age.
“Both frailty and dementia are known to increase the likelihood of functional impairment, institutionalisation and mortality. They’re important indicators of adverse outcomes. Therefore, additional attention should be paid to older people with memory decline or symptoms related to frailty. Most importantly, rapid changes in frailty status should be taken into consideration when planning geriatric care, as such changes indicate a more rapid decline in health,” Jenni Kulmala explains.
Full bibliographic information:
Jenni Kulmala, Irma Nykänen, Minna Mänty, Sirpa Hartikainen. The Association between Frailty and Dementia. A Population-Based Study. Gerontology. 2014;60(1):16-21. doi: 10.1159/000353859
Jenni Kulmala, Irma Nykänen, Sirpa Hartikainen. Frailty as a predictor of all-cause mortality in older men and women. Geriatr Gerontol Int. 2014 Mar 25. doi: 10.1111/ggi.12190. [Epub ahead of print].
Dr Jenni Kulmala, the Gerontology Research Center, University of Jyväskylä, Finland, jenni.kulmala (at) jyu.fi, tel. +358 40 805 3568
Professor Sirpa Hartikainen, University of Eastern Finland, sirpa.hartikainen (at) uef.fi, tel +358 40 3553784
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