Frailty and Risks of Dementia Among Middle-Aged and Older Adults: Evidence From Three Prospective Cohort Studies
Author(s)
Xin Ye, PhD.
Assistant Professor, Fudan University, Shanghai, China.
Assistant Professor, Fudan University, Shanghai, China.
OBJECTIVES: Frailty and dementia are closely related in the aging population, but the longitudinal analysis of frailty status changes in Chinese middle-aged and older adults is limited. This study aimed to explore the associations between frailty and the risks of dementia.
METHODS: Datasets from three prospective cohorts, namely the China Health and Retirement Longitudinal Study (CHARLS), Health and Retirement Study (HRS), and English Longitudinal Study of Ageing (ELSA), were used. A total of 31,784 participants were included in the baseline frailty status analysis, and 25,414 were included in the changes in frailty status analysis. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI).
RESULTS: In the baseline frailty status analysis, pre-frail and frail participants had a significantly higher risk of developing dementia (CHARLS: frail HR = 1.53, 95% CI 1.38-1.70; pre - frail HR = 1.17, 95% CI 1.07-1.28; HRS and ELSA showed similar trends). For changes in frailty status, robust participants who transitioned to frail status had an increased risk of dementia (CHARLS: HR = 2.08, 95% CI 1.53-2.84; HRS: HR = 2.75, 95% CI 1.49-5.06). Baseline pre-frail participants who advanced to frail status also had a significantly elevated risk compared to those with stable pre-frail status. Regarding total FI and change in FI (ΔFI), participants in the upper and middle tertiles of total FI had a greater risk of dementia. Participants in the upper tertile of ΔFI had a significantly increased risk of dementia than those in the lower tertile.
CONCLUSIONS: The study reveals a strong link between frailty progression and an increased risk of dementia. Those who shift from a robust state to a frail state are at particularly high risk. This finding emphasizes the need for proactive and tailored healthcare approaches to manage and delay the onset and progression of frailty.
METHODS: Datasets from three prospective cohorts, namely the China Health and Retirement Longitudinal Study (CHARLS), Health and Retirement Study (HRS), and English Longitudinal Study of Ageing (ELSA), were used. A total of 31,784 participants were included in the baseline frailty status analysis, and 25,414 were included in the changes in frailty status analysis. Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (CI).
RESULTS: In the baseline frailty status analysis, pre-frail and frail participants had a significantly higher risk of developing dementia (CHARLS: frail HR = 1.53, 95% CI 1.38-1.70; pre - frail HR = 1.17, 95% CI 1.07-1.28; HRS and ELSA showed similar trends). For changes in frailty status, robust participants who transitioned to frail status had an increased risk of dementia (CHARLS: HR = 2.08, 95% CI 1.53-2.84; HRS: HR = 2.75, 95% CI 1.49-5.06). Baseline pre-frail participants who advanced to frail status also had a significantly elevated risk compared to those with stable pre-frail status. Regarding total FI and change in FI (ΔFI), participants in the upper and middle tertiles of total FI had a greater risk of dementia. Participants in the upper tertile of ΔFI had a significantly increased risk of dementia than those in the lower tertile.
CONCLUSIONS: The study reveals a strong link between frailty progression and an increased risk of dementia. Those who shift from a robust state to a frail state are at particularly high risk. This finding emphasizes the need for proactive and tailored healthcare approaches to manage and delay the onset and progression of frailty.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD130
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Geriatrics