Association between the frailty index and vascular brain damage: The Treviso Dementia (TREDEM) registry

Maurizio Gallucci; Alberto Grassi; Lucia Focella; Francesca Grassivaro; Chiara Da Ronch; Marco Gallucci; Emanuele Marzetti

doi:10.1016/j.exger.2022.111894

Association between the frailty index and vascular brain damage: The Treviso Dementia (TREDEM) registry

Exp Gerontol. 2022 Oct 1:167:111894. doi: 10.1016/j.exger.2022.111894. Epub 2022 Jul 15.

Authors

Maurizio Gallucci¹, Alberto Grassi², Lucia Focella³, Francesca Grassivaro³, Chiara Da Ronch³, Marco Gallucci⁴, Emanuele Marzetti⁵

Affiliations

¹ Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, 31100 Treviso, Italy,; ODV Associazione Alzheimer Treviso, 31100 Treviso, Italy. Electronic address: maurizio.gallucci@aulss2.veneto.it.
² Department of Statistical Sciences, University of Padova, 35121 Padova, Italy.
³ Cognitive Impairment Center, Local Health Authority n. 2 Marca Trevigiana, 31100 Treviso, Italy.
⁴ Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua Medical School, 35128 Padova, Italy.
⁵ Department of Geriatrics and Orthopedics, Università Cattolica del Sacro Cuore, Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, Italy.

PMID: 35843350
DOI: 10.1016/j.exger.2022.111894

Abstract

Purpose: An association between frailty and vascular brain damage (VBD) has been described in older adults. However, most studies have identified frailty according to the phenotypic model. It is less clear whether frailty, operationalized as an accumulation of health deficits, is associated with the presence and severity of VBD. The present study was therefore undertaken to verify whether a 50-item frailty index (FI) is related to VBD in a large and relatively unselected cohort of attendees of a memory clinic.

Materials and methods: The TREDEM (Treviso Dementia) registry includes retrospective observational data of 1584 participants. A modified FI was calculated from 50 variables comprising diseases, disability, behavioral disorders, and blood biochemistry. The presence and severity of VBD, including leukoaraiosis, lacunes, larger infarctions and the hierarchical vascular rating scale (HVRS), were determined based on brain computerized tomography imaging. Multiple logistic regression models were built according to the stepwise method.

Results: Mean age of the 1584 participants was 79.6 ± 7.5 years and 1033 (65.2 %) were females. The average number of health deficits was 11.6 ± 6.2, corresponding to an FI of 0.23 ± 0.12 (range: 0.00-0.56). Each 0.01-point increase in the FI was associated with an increased probability of leukoaraiosis (+2.3 %) and severe leukoaraiosis (+5 %), lacunas in the basal ganglia (+1.73 %), occipital lobes (+2.7 %), parietal lobes (+3 %), frontal lobes (+3.6 %), temporal lobes (+4.2 %), and thalamus (+4.4 %). Moreover, an increase of 0.01 points in the FI was associated with a 3.1 % increase in the probability of HVRS score (≥2).

Conclusion: An FI based on routine clinical and laboratory variables was associated with the presence, degree, and some localizations of VBD in a population of older adults with cognitive decline. This frailty assessment tool may therefore be used to identify individuals at risk of developing cerebrovascular disease and, consequently, to implement strategies for vascular risk factor control.

Keywords: Alzheimer; Dementia; Frailty index; Mild cognitive impairment; TREDEM; Vascular brain damage.

Publication types

Observational Study

MeSH terms

Aged
Aged, 80 and over
Brain / diagnostic imaging
Dementia*
Female
Frail Elderly
Frailty*
Geriatric Assessment
Humans
Leukoaraiosis*
Male
Registries
Retrospective Studies