ArticleBMC medicine2021
Frailty and the risk of dementia: is the association explained by shared environmental and genetic factors?
Article in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Multi-Concept Frailty Predicts the Late-Life Occurrence of Cognitive Decline or Dementia: An Updated Systematic Review and Meta-Analysis of Longitudinal Studies.Frontiers in aging neuroscience · 2022Pooled it
- Association Between the Frailty and Cognitive Impairment Among Patients With Hypertension-A Post Hoc Analysis of the SPRINT Trial.Journal of the American Heart Association · 2023Trial
- Comparative Analysis by Machine Learning of Geriatric Frailty and Alzheimer's Disease Classification Using Independent Datasets.Life (Basel, Switzerland) · 2026Article
- Medicare costs and home time loss among fee-for-service beneficiaries by frailty and dementia status.The Journal of frailty & aging · 2026Article
- Genetic mechanisms, brain structures, and peripheral biomarkers mediate the relationship between physical frailty and neuropsychiatric disorders.Journal of advanced research · 2026Article
- Association of frailty with dementia and the impact of frailty on antihypertensive treatment protection against dementia in older hypertensive adults.Age and ageing · 2026Article
- Bioenergetics and lipid metabolism in Alzheimer's disease: From cell biology to systemic health.Journal of internal medicine · 2026Review
- Predicting cardiovascular morbidity and mortality with SCORE2 (OP) and Framingham risk estimates in combination with indicators of biological ageing.Age and ageing · 2025Article
- Association of Longitudinal Trajectories of Physical Frailty With Dementia Status in Older Adults: A National Cohort Study.International journal of geriatric psychiatry · 2025Article
- Sustained frailty remission and dementia risk in older adults: A longitudinal study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Associations of Orthostatic Hypotension and Frailty With Dementia and Mortality in Older Adults: A Population-Based Cohort Study.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Performance of probable dementia classification in a European multi-country survey.Scientific reports · 2024Article
- Frailty Indices and Their Importance in Elderly Patients: A Perspective Review.Journal of community hospital internal medicine perspectives · 2024Review
- Article
- Predicting Short-Term Mortality in Older Patients Discharged from Acute Hospitalizations Lasting Less Than 24 Hours.Clinical epidemiology · 2023Article
- Is There a Sex-Frailty Paradox in Dementia?The journal of nutrition, health & aging · 2023Article
- Liver Enzymes in a Cohort of Community-Dwelling Older Persons: Focus on Sex Contribution.Nutrients · 2022Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundFrailty has been identified as a risk factor for cognitive impairment and dementia. However, it is not known whether familial factors, such as genetics and shared environmental factors, underlie this association. We analyzed the association between frailty and the risk of dementia in a large twin cohort and examined the role of familial factors in the association.
methodsThe Rockwood frailty index (FI) based on 44 health deficits was used to assess frailty. The population-level association between FI and the risk of all-cause dementia was analyzed in 41,550 participants of the Screening Across the Lifespan Twin (SALT) study (full sample, aged 41-97 years at baseline), using Cox and competing risk models. A subsample of 10,487 SALT participants aged 65 and older who received a cognitive assessment (cognitive sample) was used in a sensitivity analysis to assess the effect of baseline cognitive level on the FI-dementia association. To analyze the influence of familial effects on the FI-dementia association, a within-pair analysis was performed. The within-pair model was also used to assess whether the risk conferred by frailty varies by age at FI assessment.
resultsA total of 3183 individuals were diagnosed with dementia during the 19-year follow-up. A 10% increase in FI was associated with an increased risk of dementia (hazard ratio [HR] 1.17 (95% confidence interval [CI] 1.07, 1.18)) in the full sample adjusted for age, sex, education, and tobacco use. A significant association was likewise found in the cognitive sample, with an HR of 1.13 (95% CI 1.09, 1.20), adjusted for age, sex, and cognitive level at baseline. The associations were not attenuated when adjusted for APOE ɛ4 carrier status or considering the competing risk of death. After adjusting for familial effects, we found no evidence for statistically significant attenuation of the effect. The risk conferred by higher FI on dementia was constant after age 50 until very old age.
conclusionsA higher level of frailty predicts the risk of dementia and the association appears independent of familial factors. Targeting frailty might thus contribute to preventing or delaying dementia.
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