Neuropathologic burden and the degree of frailty in relation to global cognition and dementia
To test the hypothesis that degree of frailty and neuropathologic burden independently contribute to global cognition and odds of dementia. This was a secondary analysis of a prospective cohort study of older adults living in Illinois. Participants underwent an annual neuropsychological and clinical...
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Veröffentlicht in: | Neurology 2020-12, Vol.95 (24), p.e3269-e3279 |
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creator | Wallace, Lindsay M.K. Theou, Olga Darvesh, Sultan Bennett, David A. Buchman, Aron S. Andrew, Melissa K. Kirkland, Susan A. Fisk, John D. Rockwood, Kenneth |
description | To test the hypothesis that degree of frailty and neuropathologic burden independently contribute to global cognition and odds of dementia.
This 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.
Both 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 (χ
[2] 72.64;
< 0.0001) and explained an additional 11%-12% of the variance in the outcomes.
Dementia 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. |
doi_str_mv | 10.1212/WNL.0000000000010944 |
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This 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.
Both 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 (χ
[2] 72.64;
< 0.0001) and explained an additional 11%-12% of the variance in the outcomes.
Dementia 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.</description><identifier>ISSN: 0028-3878</identifier><identifier>EISSN: 1526-632X</identifier><identifier>DOI: 10.1212/WNL.0000000000010944</identifier><identifier>PMID: 32989103</identifier><language>eng</language><publisher>United States: American Academy of Neurology</publisher><subject>Aged ; Aged, 80 and over ; Cognition Disorders - epidemiology ; Cognition Disorders - physiopathology ; Comorbidity ; Dementia - epidemiology ; Dementia - pathology ; Dementia - physiopathology ; Female ; Frailty - epidemiology ; Frailty - physiopathology ; Humans ; Illinois - epidemiology ; Male ; Prospective Studies ; Regression Analysis</subject><ispartof>Neurology, 2020-12, Vol.95 (24), p.e3269-e3279</ispartof><rights>American Academy of Neurology</rights><rights>2020 American Academy of Neurology.</rights><rights>2020 American Academy of Neurology 2020 American Academy of Neurology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5196-80740df58e5db096b293c5b614b38277ec6ba3b97f1acb58fa08bf9019b9f3033</citedby><cites>FETCH-LOGICAL-c5196-80740df58e5db096b293c5b614b38277ec6ba3b97f1acb58fa08bf9019b9f3033</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32989103$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wallace, Lindsay M.K.</creatorcontrib><creatorcontrib>Theou, Olga</creatorcontrib><creatorcontrib>Darvesh, Sultan</creatorcontrib><creatorcontrib>Bennett, David A.</creatorcontrib><creatorcontrib>Buchman, Aron S.</creatorcontrib><creatorcontrib>Andrew, Melissa K.</creatorcontrib><creatorcontrib>Kirkland, Susan A.</creatorcontrib><creatorcontrib>Fisk, John D.</creatorcontrib><creatorcontrib>Rockwood, Kenneth</creatorcontrib><title>Neuropathologic burden and the degree of frailty in relation to global cognition and dementia</title><title>Neurology</title><addtitle>Neurology</addtitle><description>To test the hypothesis that degree of frailty and neuropathologic burden independently contribute to global cognition and odds of dementia.
This 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.
Both 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 (χ
[2] 72.64;
< 0.0001) and explained an additional 11%-12% of the variance in the outcomes.
Dementia 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.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cognition Disorders - epidemiology</subject><subject>Cognition Disorders - physiopathology</subject><subject>Comorbidity</subject><subject>Dementia - epidemiology</subject><subject>Dementia - pathology</subject><subject>Dementia - physiopathology</subject><subject>Female</subject><subject>Frailty - epidemiology</subject><subject>Frailty - physiopathology</subject><subject>Humans</subject><subject>Illinois - epidemiology</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>Regression Analysis</subject><issn>0028-3878</issn><issn>1526-632X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkU9v1DAQxS0EotvCN0DIRy4p_pM49gUJVYUircoFBBdk2c44MXjjxXao-u3JtqUF5jLSzLzfG-kh9IKSU8ooe_3lcntKHooS1baP0IZ2TDSCs6-P0YYQJhsue3mEjkv5vh51rFdP0RFnSipK-AZ9u4Qlp72pU4ppDA7bJQ8wYzMPuE6ABxgzAE4e-2xCrNc4zDhDNDWkGdeEx5isidilcQ43s4NygB3MNZhn6Ik3scDzu36CPr87_3R20Ww_vv9w9nbbuI4q0UjSt2TwnYRusEQJyxR3nRW0tVyyvgcnrOFW9Z4aZzvpDZHWK0KVVZ4Tzk_Qm1vufrE7GNxqnk3U-xx2Jl_rZIL-dzOHSY_pl-4lF6KjK-DVHSCnnwuUqnehOIjRzJCWolnb9pxSqQ5e7e2py6mUDP7ehhJ9SEavyej_k1llL_9-8V70J4oH7lWKFXL5EZcryHoCE-t0wxOUtg0jjKwuHWkOaMF_A4fBmrc</recordid><startdate>20201215</startdate><enddate>20201215</enddate><creator>Wallace, Lindsay M.K.</creator><creator>Theou, Olga</creator><creator>Darvesh, Sultan</creator><creator>Bennett, David A.</creator><creator>Buchman, Aron S.</creator><creator>Andrew, Melissa K.</creator><creator>Kirkland, Susan A.</creator><creator>Fisk, John D.</creator><creator>Rockwood, Kenneth</creator><general>American Academy of Neurology</general><general>Lippincott Williams & Wilkins</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20201215</creationdate><title>Neuropathologic burden and the degree of frailty in relation to global cognition and dementia</title><author>Wallace, Lindsay M.K. ; Theou, Olga ; Darvesh, Sultan ; Bennett, David A. ; Buchman, Aron S. ; Andrew, Melissa K. ; Kirkland, Susan A. ; Fisk, John D. ; Rockwood, Kenneth</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5196-80740df58e5db096b293c5b614b38277ec6ba3b97f1acb58fa08bf9019b9f3033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cognition Disorders - epidemiology</topic><topic>Cognition Disorders - physiopathology</topic><topic>Comorbidity</topic><topic>Dementia - epidemiology</topic><topic>Dementia - pathology</topic><topic>Dementia - physiopathology</topic><topic>Female</topic><topic>Frailty - epidemiology</topic><topic>Frailty - physiopathology</topic><topic>Humans</topic><topic>Illinois - epidemiology</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>Regression Analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wallace, Lindsay M.K.</creatorcontrib><creatorcontrib>Theou, Olga</creatorcontrib><creatorcontrib>Darvesh, Sultan</creatorcontrib><creatorcontrib>Bennett, David A.</creatorcontrib><creatorcontrib>Buchman, Aron S.</creatorcontrib><creatorcontrib>Andrew, Melissa K.</creatorcontrib><creatorcontrib>Kirkland, Susan A.</creatorcontrib><creatorcontrib>Fisk, John D.</creatorcontrib><creatorcontrib>Rockwood, Kenneth</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wallace, Lindsay M.K.</au><au>Theou, Olga</au><au>Darvesh, Sultan</au><au>Bennett, David A.</au><au>Buchman, Aron S.</au><au>Andrew, Melissa K.</au><au>Kirkland, Susan A.</au><au>Fisk, John D.</au><au>Rockwood, Kenneth</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neuropathologic burden and the degree of frailty in relation to global cognition and dementia</atitle><jtitle>Neurology</jtitle><addtitle>Neurology</addtitle><date>2020-12-15</date><risdate>2020</risdate><volume>95</volume><issue>24</issue><spage>e3269</spage><epage>e3279</epage><pages>e3269-e3279</pages><issn>0028-3878</issn><eissn>1526-632X</eissn><abstract>To test the hypothesis that degree of frailty and neuropathologic burden independently contribute to global cognition and odds of dementia.
This 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.
Both 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 (χ
[2] 72.64;
< 0.0001) and explained an additional 11%-12% of the variance in the outcomes.
Dementia 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.</abstract><cop>United States</cop><pub>American Academy of Neurology</pub><pmid>32989103</pmid><doi>10.1212/WNL.0000000000010944</doi><oa>free_for_read</oa></addata></record> |
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subjects | Aged Aged, 80 and over Cognition Disorders - epidemiology Cognition Disorders - physiopathology Comorbidity Dementia - epidemiology Dementia - pathology Dementia - physiopathology Female Frailty - epidemiology Frailty - physiopathology Humans Illinois - epidemiology Male Prospective Studies Regression Analysis |
title | Neuropathologic burden and the degree of frailty in relation to global cognition and dementia |
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