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Published on: July 24, 2013
Sex Moderates the Association between Frailty and Mild Behavioral Impairment
D X Guan1, K Rockwood, E E Smith
1Zahinoor Ismail, 3280 Hospital Dr. NW Calgary AB, Canada T2N 4Z6, 403-210-6900, ismailz@ucalgary.ca, @11thCCD.
Background:
Frailty has been associated with cognitive markers of dementia but its relationship with behavioral markers of dementia are poorly understood.
Objectives:
To investigate the association between frailty and mild behavioral impairment (MBI), and whether this association is moderated by sex.
Design:
Cross-sectional observational study.
Participants/Setting:
219 non-dementia participants (cognitively normal and mild cognitive impairment) from the Comprehensive Assessment of Neurodegeneration and Dementia (COMPASS-ND) study.
Measurements:
Frailty was measured using the frailty index (FI) with higher scores indicating more health deficits/greater frailty. MBI symptoms were derived from Neuropsychiatric Inventory Questionnaire scores using a published algorithm with a cut-off of >0 indicating MBI symptom presence and higher scores indicating greater severity. Multivariable logistic and linear regressions adjusted for age, sex, education, and cognitive diagnosis were used to test the association between FI and MBI symptom presence and severity, respectively, with MBI as the outcome variable. An FI-by-sex interaction term was included to test for sex-dependent effects.
Results:
The FI mean and SD across the entire cohort was 0.14 ± 0.06 (median = 0.14, IQR = 0.09-0.17, range = 0.02-0.38). Higher FI scores were associated with the presence of MBI symptoms both globally and in the domains of decreased motivation, affective dysregulation, and psychosis. Higher FI scores were also associated with more severe MBI symptoms in a sex-dependent manner: both sexes reported similarly low MBI symptom severity at low (-1 SD) levels of FI but males reported 1.9x higher MBI symptom severity relative to females at high (+1 SD) levels of FI.
Conclusions:
The FI is associated with both the presence and severity of MBI, especially for males. This suggests that screening for early dementia risk should incorporate assessments of MBI for patients with frailty, and assessments of frailty for patients with MBI.
Insights
Frailty is linked to mild behavioral impairment (MBI) symptoms, particularly in males. Screening for frailty in MBI patients and MBI in frail individuals may aid early dementia risk detection.
Area of Science:
- Gerontology
- Neuroscience
- Psychiatry
Background:
- Frailty is known to correlate with cognitive dementia markers.
- The relationship between frailty and behavioral dementia markers remains unclear.
Purpose of the Study:
- To examine the association between frailty and mild behavioral impairment (MBI).
- To determine if sex moderates the frailty-MBI relationship.
Main Methods:
- A cross-sectional study of 219 non-dementia participants.
- Frailty Index (FI) and Mild Behavioral Impairment (MBI) symptoms were assessed.
- Statistical analyses explored associations and sex-dependent effects.
Main Results:
- Higher Frailty Index scores correlated with the presence and severity of MBI symptoms.
- This association was sex-dependent, with males exhibiting higher MBI severity at higher frailty levels.
- Specific MBI domains affected included decreased motivation, affective dysregulation, and psychosis.
Conclusions:
- Frailty is associated with MBI presence and severity, notably in males.
- Integrating frailty and MBI assessments may improve early dementia risk identification.
