Frailty, lifestyle, genetics and dementia risk

痴呆 医学 老年学 风险因素 人口学 内科学 疾病 社会学
作者
David Ward,Janice M. Ranson,Lindsay Wallace,David J. Llewellyn,Kenneth Rockwood
出处
期刊:Journal of Neurology, Neurosurgery, and Psychiatry [BMJ]
卷期号:93 (4): 343-350 被引量:72
标识
DOI:10.1136/jnnp-2021-327396
摘要

To optimise dementia prevention strategies, we must understand the complex relationships between lifestyle behaviours, frailty and genetics.We explored relationships between frailty index, healthy lifestyle and polygenic risk scores (all assessed at study entry) and incident all-cause dementia as recorded on hospital admission records and death register data.The analytical sample had a mean age of 64.1 years at baseline (SD=2.9) and 53% were women. Incident dementia was detected in 1762 participants (median follow-up time=8.0 years). High frailty was associated with increased dementia risk independently of genetic risk (HR 3.68, 95% CI 3.11 to 4.35). Frailty mediated 44% of the relationship between healthy lifestyle behaviours and dementia risk (indirect effect HR 0.95, 95% CI 0.95 to 0.96). Participants at high genetic risk and with high frailty had 5.8 times greater risk of incident dementia compared with those at low genetic risk and with low frailty (HR 5.81, 95% CI 4.01 to 8.42). Higher genetic risk was most influential in those with low frailty (HR 1.31, 95% CI 1.22 to 1.40) but not influential in those with high frailty (HR 1.09, 95% CI 0.92 to 1.28).Frailty is strongly associated with dementia risk and affects the risk attributable to genetic factors. Frailty should be considered an important modifiable risk factor for dementia and a target for dementia prevention strategies, even among people at high genetic risk.
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