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. 2017 Oct 23:4:178.
doi: 10.3389/fmed.2017.00178. eCollection 2017.

The Impact of Frailty on the Risk of Conversion from Mild Cognitive Impairment to Alzheimer's Disease: Evidences from a 5-Year Observational Study

Alessandro Trebbastoni  1 , Marco Canevelli  1 , Fabrizia D'Antonio  1 , Letizia Imbriano  1 , Livia Podda  1 , Lidia Rendace  1 , Alessandra Campanelli  1 , Valentina Celano  1 , Giuseppe Bruno  1 , Carlo de Lena  1
Affiliations

The Impact of Frailty on the Risk of Conversion from Mild Cognitive Impairment to Alzheimer's Disease: Evidences from a 5-Year Observational Study

Alessandro Trebbastoni et al. Front Med (Lausanne). .

Abstract

The frailty construct has increasingly been adopted in the field of cognitive disorders. The aim of the present study was to measure frailty in a cohort of individuals with mild cognitive impairment (MCI) and to explore whether frailty measures may consent to predict the risk of conversion to dementia. We retrospectively reviewed the clinical charts of outpatients with amnesic MCI (aMCI) consecutively recruited at our Department, and followed-up for 5 years. Individual frailty status was measured by means of a frailty index (FI) consisting of 39 deficits (including signs, symptoms, diagnoses, and disabilities). Univariate analyses were used to compare the socio-demographic and clinical characteristics between subjects converting or not converting to probable Alzheimer's disease (AD) dementia over the follow-up. Risk for conversion to AD dementia was assessed using Cox regression models. Ninety-one subjects with aMCI (mean age 72.7, SD 7.1 years; women 49.5%) were consecutively recruited over a period of 12 months. Low levels of frailty were documented in the sample (mean FI score 10.0, SD 5.3). A statistically significant correlation between age and FI was observed. Overall, 58 participants converted to AD dementia over time. The Cox regression analysis showed that age (HR: 1.04, 95% CI: 1.00-1.08), male sex (HR: 0.52, 95% CI: 0.30-0.91), Mini-Mental State Examination score (HR: 0.85, 95% CI: 0.77-0.94), and FI (HR: 1.11, 95% CI: 1.05-1.18) were all significantly associated with the probability of MCI conversion. Individual's frailty status may increase the risk of conversion from a condition of MCI to overt AD dementia. The adoption of constructs comprehensively reflecting the biological decline of the aging subject may add useful estimates and information in the clinical approach to cognitive disorders.

Keywords: Alzheimer’s disease; aging; dementia; frailty; mild cognitive impairment.

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Figures

Figure 1
Figure 1
Flow chart of the study. One hundred thirty-two amnesic MCI (aMCI) patients were initially enrolled. Forty-one participants were retrospectively excluded (23 resulted were lost to follow-up; 18 did not undergo two or more clinical and neuropsychological assessments per year). Data from 91 aMCI subjects were finally considered for the present analyses.
Figure 2
Figure 2
(A) Correlation between age and frailty index (FI) in the overall sample. (B) FI values among MCI converters and MCI non-converters.
See this image and copyright information in PMC

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