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Microstructural Brain Changes Associated With Frailty in Older Adults: Insights From Diffusion Tensor Imaging.
Betul Sumbul Sekerci1, Bahar Atasoy2, Ozge Pasin3
1Department of Clinical Pharmacy, Faculty of Pharmacy, Bezmialem Vakıf University, Istanbul, Turkey.
Journal of the American Medical Directors Association
|July 10, 2025
Summary
Frailty and prefrailty in older adults are linked to reduced white matter integrity, especially in the left cingulum and forceps major. Malnutrition and sleep issues may contribute to this association.
Area of Science:
- Neuroscience
- Gerontology
- Radiology
Background:
- Frailty is a significant geriatric syndrome associated with adverse health outcomes.
- White matter integrity (WMI) is crucial for cognitive function and mobility in older adults.
- Understanding the relationship between frailty and WMI can inform interventions.
Purpose of the Study:
- To investigate the association between frailty status and WMI in older adults.
- To identify specific white matter tracts affected by frailty.
- To explore potential contributing factors to the frailty-WMI relationship.
Main Methods:
- Cross-sectional study of 125 non-demented adults aged ≥65 years.
- Frailty assessed using Fried Frailty criteria.
- Brain MRI with diffusion tensor imaging (DTI) to measure WMI.
- Statistical analyses included multinomial logistic regression and canonical correlation analysis.
Main Results:
- Frailty and prefrailty were associated with deteriorated WMI in the left cingulum and left forceps major.
- Malnutrition significantly increased frailty risk (OR 18.86).
- Lawton-Brody IADL and Epworth Sleepiness Scale scores were strong predictors of WMI changes.
Conclusions:
- Frailty and prefrailty are linked to impaired WMI, suggesting shared underlying mechanisms.
- Sleep, functionality, and nutrition are potential contributing factors.
- A multidimensional approach is essential for managing frailty.
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