Introduction

Physical frailty develops with increasing age and is a chronic state of vulnerability that is associated with disability and cognitive decline. Frailty is most often described using the physical frailty phenotype. This phenotype is assessed with five frailty components: slowness, weakness, exhaustion, weight loss and a low level of activity. Few studies have assessed the underlying structural brain abnormalities of physical frailty. We therefore examined the association between brain volumes and physical frailty.

Methods

A total of 214 non-demented participants (mean age 72.4 ± 4.9 years) were included on 2 sites (UMC Utrecht and Charité Universitätsmedizin Berlin) as part of the Biomarker Development for Postoperative Cognitive Decline study (BioCog). Participants were classified as non-frail (N=75), pre-frail (N=107) or frail (N=32) by the Fried frailty phenotype. Brain volumes (total brain, white matter, grey matter, white matter hyperintensity and intracranial volume) were automatically segmented on 3D T1 and 3D FLAIR images by the lesion prediction algorithm, a lesion filling algorithm and CAT12. All scans were checked by a radiologist (JB) for cortical infarcts and major artifacts that might hinder accurate segmentations. The associations between brain volumes and frailty were examined by linear regression analyses, corrected for age, gender, intracranial volume and study center.

Results

Participants in the frail group showed a lower total brain volume (β (95% CI)= -22.40 (-40.38 – -4.41), p=0.02) and a lower grey matter volume (β (95% CI)=-12.26 (-23.09 – -1.43), p=0.03) compared to the pre-frail group (see table 1). Participants in the frail group also showed a lower total brain volume (β (95% CI)=-19.67 (-37.84 – -1.50), p=0.03) and lower grey matter volume (β (95% CI)=-12.19 (-23.84 – -0.54), p=0.04) compared to participants in the non-frail group (see table 1). Pre-frail participants showed more cortical infarcts > 1.5 cm compared to non-frail participants (OR (95% CI)= 4.66 (1.00 – 21.73), p=0.05, see table 2). No other significant differences were found between the non-frail and pre-frail group.

Conclusion

Individuals with physical frailty showed more brain abnormalities compared to pre-frail and non-frail individuals. These brain abnormalities could be the underlying structural correlates of the physical frailty phenotype.

Acknowledgements

The authors present this abstract on behalf of the BioCog Consortium, clinicaltrials.gov identifier: NCT02265263, ethical approval number EA2/092/14 (Berlin), 14-469 (Utrecht).

References

No reference found.