Avila-Funes José Alberto, Pelletier Amandine, Meillon Céline, Catheline Gwénaëlle, Periot Olivier, Trevin O-Frenk Irene, Gonzalez-Colaço Magali, Dartigues Jean-François, Pérès Karine, Allard Michèle, Dilharreguy Bixente, Amieva Hélène
Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Université de Bordeaux, France.
J Gerontol A Biol Sci Med Sci. 2017 Jul 1;72(7):971-977. doi: 10.1093/gerona/glw347.
Frailty has been associated with increased risk of adverse-health related outcomes including cognitive impairment. However, little is know about the pathogenesis relating frailty to cognitive decline. Therefore, the main objective of this study was to investigate the association between vascular cerebral damage and frailty.
Cross-sectional study involving 176 community-dwelling participants aged 67-86 years, participating in the AMImage Study, an ancillary neuro-imaging project of the AMI cohort, a French prospective cohort including older farmers living in rural areas. Frailty was defined as proposed by Fried. 3T magnetic resonance imaging (MRI) examination was performed with anatomical, diffusion, and fluid-attenuated inversion recovery sequences. The evaluation included the assessment of white matter hyperintensities (WMH) volumes and of microstructural white matter integrity through exploration of diffusion tensor imaging (DTI) parameters.
The analyses showed that WMH volumes were higher in frail persons compared with nonfrail subgroup. Frail participants presented DTI modifications in extensive areas of white matter. In comparison with nonfrail subgroup, frail participants showed a strong association between WMH volumes and DTI changes.
These results show that subclinical cerebrovascular damage is present in the frail older person, which could support the hypothesis that frailty is a prodromal state of central nervous system vascular injury.
衰弱与包括认知障碍在内的不良健康相关结局风险增加有关。然而，关于衰弱与认知衰退之间的发病机制知之甚少。因此，本研究的主要目的是调查脑血管损伤与衰弱之间的关联。
横断面研究，纳入了176名年龄在67 - 86岁的社区居住参与者，他们参与了AMImage研究，这是AMI队列的一项辅助神经影像学项目，AMI队列是一个包括居住在农村地区的老年农民的法国前瞻性队列。衰弱按照弗里德提出的标准定义。采用解剖、扩散和液体衰减反转恢复序列进行3T磁共振成像（MRI）检查。评估包括通过扩散张量成像（DTI）参数探索来评估白质高信号（WMH）体积和微观结构白质完整性。
分析表明，与非衰弱亚组相比，衰弱者的WMH体积更高。衰弱参与者在广泛的白质区域出现DTI改变。与非衰弱亚组相比，衰弱参与者的WMH体积与DTI变化之间存在很强的关联。
这些结果表明，衰弱的老年人存在亚临床脑血管损伤，这可能支持衰弱是中枢神经系统血管损伤前驱状态的假说。
