Vascular Cerebral Damage in Frail Older Adults: The AMImage Study.
BACKGROUND
Frailty has been associated with increased risk of adverse-health related outcomes including cognitive impairment. However, little is know about the pathogenesis relating frailty to cognitive decline. Therefore, the main objective of this study was to investigate the association between vascular cerebral damage and frailty.


METHODS
Cross-sectional study involving 176 community-dwelling participants aged 67-86 years, participating in the AMImage Study, an ancillary neuro-imaging project of the AMI cohort, a French prospective cohort including older farmers living in rural areas. Frailty was defined as proposed by Fried. 3T magnetic resonance imaging (MRI) examination was performed with anatomical, diffusion, and fluid-attenuated inversion recovery sequences. The evaluation included the assessment of white matter hyperintensities (WMH) volumes and of microstructural white matter integrity through exploration of diffusion tensor imaging (DTI) parameters.


RESULTS
The analyses showed that WMH volumes were higher in frail persons compared with nonfrail subgroup. Frail participants presented DTI modifications in extensive areas of white matter. In comparison with nonfrail subgroup, frail participants showed a strong association between WMH volumes and DTI changes.


CONCLUSIONS
These results show that subclinical cerebrovascular damage is present in the frail older person, which could support the hypothesis that frailty is a prodromal state of central nervous system vascular injury.
Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.|Université de Bordeaux, France.|Centre de recherche INSERM U1219, Bordeaux, France.
José Alberto
JA
Avila-Funes
Université de Bordeaux, France.|Centre de recherche INSERM U1219, Bordeaux, France.
Amandine
A
Pelletier
Université de Bordeaux, France.|Centre de recherche INSERM U1219, Bordeaux, France.
Céline
C
Meillon
Univ. Bordeaux, INCIA, UMR 5287, Bordeaux, France.|CNRS, INCIA, UMR 5287, Bordeaux, France.|EPHE, Bordeaux, France.
Gwénaëlle
G
Catheline
CHU de Bordeaux, France.
Olivier
O
Periot
Department of Neurology and Psychiatry, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.|Neurologic Center, Centro Médico ABC, Mexico City, Mexico.
Irene
I
Trevin O-Frenk
Université de Bordeaux, France.|Centre de recherche INSERM U1219, Bordeaux, France.
Magali
M
Gonzalez-Colaço
Université de Bordeaux, France.|Centre de recherche INSERM U1219, Bordeaux, France.
Jean-François
JF
Dartigues
Université de Bordeaux, France.|Centre de recherche INSERM U1219, Bordeaux, France.
Karine
K
Pérès
Univ. Bordeaux, INCIA, UMR 5287, Bordeaux, France.|CNRS, INCIA, UMR 5287, Bordeaux, France.|EPHE, Bordeaux, France.|CHU de Bordeaux, France.
Michèle
M
Allard
Univ. Bordeaux, INCIA, UMR 5287, Bordeaux, France.|CNRS, INCIA, UMR 5287, Bordeaux, France.|EPHE, Bordeaux, France.
Bixente
B
Dilharreguy
Université de Bordeaux, France.|Centre de recherche INSERM U1219, Bordeaux, France.
Hélène
H
Amieva
D000368:Aged; D000369:Aged, 80 and over; D058070:Asymptomatic Diseases / Q000453:epidemiology; D002561:Cerebrovascular Disorders / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D059906:Neuroimaging / Q000379:methods / Q000706:statistics & numerical data; D009929:Organ Size; D012423:Rural Health / Q000706:statistics & numerical data; D013223:Statistics as Topic; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology
Diffusion tensor imaging; Frailty; Magnetic resonance imaging; Microstructural white matter integrity; White matter hyperintensities