Neuroimaging signatures of frailty: A population‐based study in community‐dwelling older adults (the Atahualpa Project)

• Published in: Geriatrics & gerontology international Vol. 17; no. 2; pp. 270 - 276
• Main Authors: Del Brutto, Oscar H, Mera, Robertino M, Cagino, Kristen, Fanning, Kathryn D, Milla‐Martinez, Marleni F, Nieves, Johnathan L, Zambrano, Mauricio, Sedler, Mark J
• Format: Journal Article
• Language: English
• Published: Japan Blackwell Publishing Ltd 01.02.2017
• Subjects: Age Factors; Aged; Aged, 80 and over; Atrophy; Brain - diagnostic imaging; Brain - pathology; Cross-Sectional Studies; Edmonton Frailty Scale; Female; Frail Elderly; Frailty; Frailty - diagnostic imaging; Frailty - pathology; Geriatric Assessment; global cortical atrophy; Humans; Independent Living; Magnetic Resonance Imaging; Male; Medical imaging; Middle Aged; Neuroimaging; Older people; white matter hyperintensities; frailty; magnetic resonance imaging; Edmonton Frailty Scale; global cortical atrophy; white matter hyperintensities
• ISSN: 1444-1586; 1447-0594
• DOI: 10.1111/ggi.12708

Aims Frailty is a geriatric state of physical vulnerability that might be associated with cognitive decline in the absence of a concurrent neurodegenerative disorder. This assumes that neuroimaging studies are normal, but such examinations have rarely been considered for a frailty work‐up. The present study identifies neuroimaging signatures in older adults interviewed with the Edmonton Frail Scale (EFS). Methods Community‐dwellers aged ≥60 years enrolled in the Atahualpa Project were invited to undergo brain magnetic resonance imaging. Using generalized regression models, we evaluated the association between frailty and diffuse cortical and subcortical brain damage, after adjusting for relevant confounders. Multivariate models estimated the interaction of age in the association between frailty and these neuroimaging signatures. Results Out of 298 participants (mean age 70 ± 8 years, 57% women), 151 (51%) had moderate‐to‐severe cortical atrophy and 74 (25%) had moderate‐to‐severe white matter hyperintensities of presumed vascular origin. Mean EFS scores were 5 ± 3 points, with 140 (47%) individuals classified as robust, 65 (22%) as pre‐frail and 93 (31%) as frail. Multivariate models showed a significant association between cortical atrophy with the continuous (P = 0.002) and the categorized (P = 0.008) EFS score. The relationship between white matter hyperintensities and the EFS was marginal. According to interaction models, prefrail or frail individuals aged ≥67 years presented more prominent neuroimaging signatures of diffuse cortical or subcortical damage than their robust counterparts. Conclusions Neuroimaging signatures of frailty are mainly related to age. This reinforces the importance of early frailty detection to reduce its catastrophic consequences. Geriatr Gerontol Int 2017; 17: 270–276.