Lancet study shows how symptoms of Alzheimer’s are more pronounced in frail people
New research published in The Lancet Neurology journal suggests that frailty makes older adults more susceptible to Alzheimer’s dementia.
It also moderates the effects of dementia-related brain changes on dementia symptoms. The findings suggest that frailty should be considered in clinical care and management of Alzheimer’s dementia.
The study found that older adults (59 years and older) with higher levels of frailty were more likely to have both Alzheimer’s disease-related brain changes and symptoms of dementia. Others with substantial brain changes, but who were not frail, showed fewer clinical symptoms.
“This indicates that a ‘frail brain’ might be more susceptible to neurological problems like dementia”
“By reducing an individual’s physiological reserve, frailty could trigger the clinical expression of dementia when it might remain asymptomatic in someone who is not frail,” explains Professor Kenneth Rockwood from Nova Scotia Health Authority and Dalhousie University, Canada, who led the study.
He added: “This indicates that a ‘frail brain’ might be more susceptible to neurological problems like dementia as it is less able to cope with the pathological burden.”
Alzheimer’s Disease is one of the more common forms of dementia. It is estimated by 2020 close to 15% of the world’s Alzheimer’s burden will be in India.
“This is an enormous step in the right direction for Alzheimer’s research. Our findings suggest that the expression of dementia symptoms results from several causes, and Alzheimer’s disease-related brain changes are likely to be only one factor in a whole cascade of events that lead to clinical symptoms. Understanding how individual risk factors work together to give rise to late-life dementia is likely to offer a new way to develop targeted treatment options,” said Professor Rockwood.
The findings support the idea that late-life dementia (and particularly Alzheimer’s disease) is a complex phenomenon rather than a single disease entity marked by genetic risk or single protein abnormalities in the brain. However, the authors caution that this study is a cross-sectional comparison of pathology data from a single database that only includes adults living in Illinois, USA.
Previous research has shown that some people with Alzheimer’s disease-related brain changes (eg, amyloid deposition) can have few characteristic symptoms of the disease (cognitive and functional decline), whereas others with few brain changes may have symptoms. These discrepancies suggest that some hidden factors might affect the relationship between Alzheimer’s disease-related brain changes and Alzheimer’s dementia.
