Frailty in Older Adults with Mild Dementia: Dementia with Lewy Bodies and Alzheimer’s Disease

Abstract

Introduction: The aim of the study is to describe the frequency of frailty in people with a new diagnosis of mild dementia due to Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). Methods: This is a secondary analysis of the Dementia Study of Western Norway (Demvest). For this study, we analysed a sample of 186 patients, 116 with AD and 70 with DLB. Subjects were included at a time in which mild dementia was diagnosed according to consensus criteria after comprehensive standardized assessment. Frailty was evaluated retrospectively using a frailty index generated from existing data. The cut-off value used to classify an older adult as frail was 0.25. Results: The prevalence of frailty was 25.81% (n = 48). In the DLB group, 37.14% (n = 26) were classified as frail, compared to 18.97% (n = 22) of those with AD (p < 0.001). The adjusted multivariate analysis revealed an OR of 2.45 (1.15–5.23) for being frail in those with DLB when using AD as the reference group. Conclusion: Frailty was higher than expected in both types of dementia. The prevalence of frailty was higher in those with DLB compared to AD. This new finding underscores the need for a multi-systems approach in both dementias, with a particular focus on DLB.

Neuropsychiatric Symptoms and Functional Decline in Alzheimerʼs Disease and Lewy Body Dementia

“…We have shown that attention is associated with ADL in PDD, 38 as well as sleep disorders and parkinsonism. 13,39 The association between longitudinally assessed NPSs and functional trajectory is in line with the previously evidenced unstable course of NPSs observed in both AD and LDB, 8 and underline why regularly and structured assessments of NPSs are important. Current data imply that both prevention and treatment of NPSs may be beneficial also with regard to functional decline.…”

“…[10][11][12] In people living with LBD, NPSs, comorbidity, frailty, and functional impairment are more frequent and severe than for people with AD. 8,13,14 These characteristics make this group more prone to dependency and to a worse prognosis when compared with other common dementias. 13,14 Little is known regarding the impact of the total NPS burden on the functional trajectories in people living with dementia.…”

“…8,13,14 These characteristics make this group more prone to dependency and to a worse prognosis when compared with other common dementias. 13,14 Little is known regarding the impact of the total NPS burden on the functional trajectories in people living with dementia. Previous studies in AD report associations with hallucinations, delusions, apathy, and aggression, but findings are not conclusive.…”

Clinical and Neuropsychological Correlates of Prefrailty Syndrome

“…Frailty is a common clinical syndrome in older adults due to age-related cumulative decline in multiple physiological systems, associated with negative health outcomes, including deterioration of daily living activities, disability, institutionalization, morbidity, and mortality (1). Cross-sectional and longitudinal research has demonstrated that older adults with physical frailty exhibit poorer cognitive performance and greater risk of cognitive decline and dementia than individuals without frailty (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15), and that individuals with cognitive decline or dementia show a higher risk of physical frailty (16)(17)(18). It has also been demonstrated that the coexistence of physical frailty and cognitive impairment (cognitive frailty), ranging from 1 to 5% in community-dwelling older adults (19), increases the risk of mortality (20)(21)(22)(23)(24)(25), functional disability (26), and incident neurocognitive disorders (9,27) in later life.…”

Stable complexes of neuropsychiatric symptoms in patients with vascular dementia with different localization of brain pathological focuses

“…Презентація психопатологічної симптоматики різниться залежно від типів деменції, а частота презентації подібної симптоматики може змінюватись залежно від стадій деменції. На ранніх стадіях хвороби, зокрема, переважають депресія, дезінгібіція, апатія та порушення сну, а прогресування хвороби призводить до збільшення частоти появи психопатологічних симптомів, як-от марення, галюцинацій та агресії [3][4][5]. При судинній деменції розлади сну, збудження, депресія та тривожність не пов'язані з конкретною стадією захворювання [6].…”