Changes in Frailty Predict Changes in Cognition in Older Men: The Honolulu-Asia Aging Study.
As cognitive decline mostly occurs in late life, where typically it co-exists with many other ailments, it is important to consider frailty in understanding cognitive change.



Here, we examined the association of change in frailty status with cognitive trajectories in a well-studied cohort of older Japanese-American men.



Using the prospective Honolulu-Asia Aging Study (HAAS), 2,817 men of Japanese descent were followed (aged 71-93 at baseline). Starting in 1991 with follow-up health assessments every two to three years, cognition was measured using the Cognitive Abilities Screening Instrument (CASI). For this study, health data was used to construct an accumulation of deficits frailty index (FI). Using six waves of data, multilevel growth curve analyses were constructed to examine simultaneous changes in cognition in relation to changes in FI, controlling for baseline frailty, age, education, and APOE-ɛ4 status.



On average, CASI scores declined by 2.0 points per year (95% confidence interval 1.9-2.1). Across six waves, each 10% within-person increase in frailty from baseline was associated with a 5.0 point reduction in CASI scores (95% confidence interval 4.7-5.2). Baseline frailty and age were associated both with lower initial CASI scores and with greater decline across the five follow-up assessments (p < 0.01).



Cognition is adversely affected by impaired health status in old age. Using a multidimensional measure of frailty, both baseline status and within-person changes in frailty were predictive of cognitive trajectories.
Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Joshua J
JJ
Armstrong
Geriatric Medicine Research Unit, Nova Scotia Health Authority, Halifax, NS, Canada.
Judith
J
Godin
Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA.
Lenore J
LJ
Launer
Pacific Health Research & Education Institute, Honolulu, Hawaii, USA.
Lon R
LR
White
Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Arnold
A
Mitnitski
Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University, Halifax, NS, Canada.
Kenneth
K
Rockwood
Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University, Halifax, NS, Canada.|Geriatric Medicine Research Unit, Nova Scotia Health Authority, Halifax, NS, Canada.
Melissa K
MK
Andrew
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology*; D001213:Asian; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D015577:Geriatric Assessment; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D008297:Male; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests
Aging; cognition; cohort studies; frail elderly; risk factors