title: Is frailty a prodromal stage of vascular dementia? Results from the Three-City Study.
abstract: OBJECTIVE
  To investigate the relationship between frailty and incident vascular dementia (VaD).
  
  
  METHODS
  Seven-year longitudinal study.
  
  
  METHODS
  Three-City Study, a French prospective study designed to evaluate the risk of dementia and cognitive decline attributable to vascular risk factors.
  
  
  METHODS
  Five thousand four hundred eighty community-dwelling persons aged 65 to 95.
  
  
  METHODS
  An expert committee established a clinical diagnosis of VaD. Frailty was defined as having at least three of the following criteria: weight loss, weakness, exhaustion, slowness, and low physical activity. Participants with prior stroke or prevalent dementia at baseline were excluded from analyses. Multivariate models were used to evaluate the relationship between frailty and incident VaD.
  
  
  RESULTS
  At baseline, 6.5% of participants were classified as frail. After 7 years of follow-up, 54 persons were diagnosed with VaD, seven of whom where frail. In the proportional hazards models, frailty was marginally associated with greater risk of all types of dementia and was not associated with incident Alzheimer's disease, but frailty status was independently associated with incident VaD.
  
  
  CONCLUSIONS
  Frailty is a major risk factor for incident VaD, so its identification could contribute to better estimates of the risk of VaD in elderly adults.
authors.affiliation: Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Avila-Funes
authors.forename: Laure
authors.initials: L
authors.lastname: Carcaillon
authors.forename: Catherine
authors.initials: C
authors.lastname: Helmer
authors.forename: Isabelle
authors.initials: I
authors.lastname: Carrière
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouaud
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.forename: Hélène
authors.initials: H
authors.lastname: Amieva
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D016330:Frail Elderly; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D062706:Prodromal Symptoms; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors