Association of Longitudinal Trajectories of Physical Frailty With Dementia Status in Older Adults: A National Cohort Study

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2025-02-03 DOI:10.1002/gps.70051

Fen Ye, Weijiao Zhou, Junlan Pu, Haobo Chen, Xiurong Wang, Jung Jae Lee

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Abstract

Background and Objectives

The longitudinal patterns of change in physical frailty and their associations with the subsequent dementia risk remain unclear. This study aimed to (1) explore the long-term trajectories of physical frailty over a 6-year period in older adults without dementia at baseline; (2) identify the socio-demographic and health-related factors associated with different physical frailty trajectories; and (3) examine the longitudinal relationships between different physical frailty trajectories and subsequent risk of dementia.

Research Design and Methods

This national cohort study used data from the National Health and Aging Trends Study (NHATS) conducted in the United States from 2015 to 2021 and included adults aged ≥ 65 without dementia (n = 2245) at baseline in 2015. Group-based trajectory modeling was used to describe the longitudinal changes. Socio-demographic and health-related characteristics were compared across the identified physical frailty trajectories using bivariate analyses, employing Rao–Scott chi-square tests for categorical variables and design-based F-tests for continuous variables. Multinomial logistic regression analyses were conducted to examine the relationships between different frailty trajectories and subsequent dementia status.

Results

Three frailty trajectories were identified: low-stable (74.00%), low-increasing (21.14%), and high-level (4.86%). Participants in the low-increasing and high-level groups were predominantly older, female, minorities, unmarried, and less educated and had a lower income, more comorbidities, and greater anxiety and depression symptoms (p < 0.001). Compared with the low-stable group, older adults in the low-increasing group had higher risk of possible dementia (RRR: 2.37, 95% CI: 1.41–3.97, p < 0.001) and probable dementia (RRR: 1.71, 95% CI: 1.08–2.73, p = 0.02); similarly, older adults in the high-level group had higher risks of possible dementia (RRR: 4.24, 95% CI: 1.74–10.36, p < 0.001) and probable dementia (RRR: 2.99, 95% CI: 1.32–6.76, p = 0.01). No significant differences were found in the risk of dementia between the high-level frailty group and the low-increasing frailty group (p > 0.05).

Conclusion and Implications

This study highlighted the importance of regular frailty monitoring for early detection and informed future interventions that could delay frailty progression and potentially reduce dementia risk.

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老年人身体虚弱与痴呆状态的纵向轨迹的关联：一项国家队列研究

背景和目的身体虚弱变化的纵向模式及其与随后痴呆风险的关联尚不清楚。本研究旨在(1)探索无痴呆的老年人在6年内身体虚弱的长期轨迹；(2)确定与不同体质脆弱轨迹相关的社会人口和健康相关因素；(3)研究不同身体虚弱轨迹与痴呆后续风险之间的纵向关系。研究设计与方法本国家队列研究使用了2015年至2021年在美国进行的国家健康与老龄化趋势研究（NHATS）的数据，纳入了2015年基线时年龄≥65岁且无痴呆的成年人（n = 2245）。采用基于群的轨迹建模来描述纵向变化。社会人口统计学和健康相关特征通过双变量分析进行比较，分类变量采用Rao-Scott卡方检验，连续变量采用基于设计的f检验。进行多项逻辑回归分析以检验不同的衰弱轨迹与随后的痴呆状态之间的关系。结果鉴定出低稳定（74.00%）、低增加（21.14%）和高水平（4.86%）3种脆弱性轨迹。低增长组和高增长组的参与者主要是老年人、女性、少数民族、未婚、受教育程度较低、收入较低、合并症较多、焦虑和抑郁症状较多(p <；0.001)。与低稳定组相比，低稳定组的老年人可能发生痴呆的风险更高(RRR: 2.37, 95% CI: 1.41-3.97, p <；0.001)和可能的痴呆（RRR: 1.71, 95% CI: 1.08-2.73, p = 0.02）；同样，高水平组的老年人可能患痴呆的风险更高(RRR: 4.24, 95% CI: 1.74-10.36, p <；0.001)和可能的痴呆（RRR: 2.99, 95% CI: 1.32 ~ 6.76, p = 0.01）。高衰弱组和低衰弱组痴呆风险无显著差异(p >；0.05)。结论和意义本研究强调了定期虚弱监测对早期发现和知情的未来干预的重要性，这些干预可以延缓虚弱进展并潜在地降低痴呆风险。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.