Petermann-Rocha Fanny, Lyall Donald M, Gray Stuart R, Esteban-Cornejo Irene, Quinn Terence J, Ho Frederick K, Pell Jill P, Celis-Morales Carlos
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Lancet Healthy Longev. 2020 Nov;1(2):e58-e68. doi: 10.1016/S2666-7568(20)30007-6. Epub 2020 Nov 2.
Dementia is associated with a high burden of dependency and disability. Physical frailty (hereafter referred to as frailty) is a multisystem dysregulation that has been identified as a risk factor for dementia. The aim of this study was to examine the association of frailty and its individual components with all-cause dementia incidence in a cohort of UK adults.
Participants in UK Biobank with data available for dementia incidence and without any form of dementia at baseline were included in this prospective study. Frailty was defined using a modified version of the frailty phenotype based on five individual components (weight loss, tiredness, physical activity, gait speed, and grip strength), with participants classified as pre-frail if they fulfilled one or two criteria or frail if they fulfilled three or more. Associations between frailty and dementia incidence were investigated using Cox proportional hazard models adjusted for sociodemographic factors, lifestyle factors, and morbidity count. The population attributable fraction was also estimated.
Of 502 535 participants in UK Biobank, 143 215 met the inclusion criteria and were included in our analyses. 68 500 (47·8%) of the participants were pre-frail and 5565 (3·9%) were frail. During a median follow-up period of 5·4 years, 726 individuals developed dementia. Compared with non-frail individuals, the risk of dementia incidence was increased for individuals with pre-frailty (hazard ratio 1·21 [95% CI 1·04-1·42]) and frailty (1·98 [1·47-2·67]) in the fully adjusted model. Of the five components used to define frailty, weight loss (1·31 [1·09-1·58]), tiredness (1·48 [1·18-1·86]), low grip strength (1·38 [1·17-1·63]), and slow gait speed (1·55 [1·22-1·96]) were independently associated with incident dementia. Based on population attributable fraction analyses, in the study sample, pre-frailty and frailty accounted for 9·9% and 8·6% of dementia cases, respectively.
Individuals with pre-frailty and frailty were at a higher risk of dementia incidence even after adjusting for a wide range of confounding factors. Early detection and interventions for frailty could translate into prevention or delayed onset of dementia.
None.
痴呆症与高负担的依赖和残疾相关。身体虚弱（以下简称虚弱）是一种多系统失调，已被确定为痴呆症的一个风险因素。本研究的目的是在一组英国成年人队列中，研究虚弱及其各个组成部分与全因痴呆症发病率之间的关联。
本前瞻性研究纳入了英国生物银行中可获得痴呆症发病率数据且基线时无任何形式痴呆症的参与者。虚弱是根据虚弱表型的修改版本来定义的，该版本基于五个个体组成部分（体重减轻、疲劳、身体活动、步速和握力），如果参与者符合一或两条标准则被分类为虚弱前期，如果符合三条或更多标准则被分类为虚弱。使用经社会人口学因素、生活方式因素和发病计数调整的Cox比例风险模型，研究虚弱与痴呆症发病率之间的关联。还估计了人群归因分数。
在英国生物银行的502535名参与者中，143215名符合纳入标准并被纳入我们的分析。68500名（47.8%）参与者为虚弱前期，5565名（3.9%）为虚弱。在中位随访期5.4年期间，726人患上了痴呆症。在完全调整模型中，与非虚弱个体相比，虚弱前期个体（风险比1.21[95%置信区间1.04 - 1.42]）和虚弱个体（1.98[1.47 - 2.67]）患痴呆症的风险增加。用于定义虚弱的五个组成部分中，体重减轻（1.31[1.09 - 1.58]）、疲劳（1.48[1.18 - 1.86]）、握力低（1.38[1.17 - 1.63]）和步速慢（1.55[1.22 - 1.96]）与新发痴呆症独立相关。基于人群归因分数分析，在研究样本中，虚弱前期和虚弱分别占痴呆症病例的9.9%和8.6%。
即使在调整了广泛的混杂因素后，虚弱前期和虚弱个体患痴呆症的风险更高。对虚弱的早期检测和干预可能转化为痴呆症的预防或发病延迟。
无。
