Global brain atrophy, white matter hypointensity tied to prefrailty

In otherwise cognitively healthy older adults, a prefrail state appears to be correlated with global brain atrophy and white matter hypointensity, a recent Japan study has found.

Researchers enrolled 670 cognitively healthy adults (mean age 70.1 years) who underwent magnetic resonance imaging studies for the measurement of total brain volume (TBV), hippocampal volume, white matter hyopointensities volume (WMHV), and estimated total intracranial volume (eTIV).

The Japanese version of the Cardiovascular Health Study criteria was used to classify participants as robust or prefrail.

Ten participants were eventually deemed to be frail, while 241 (35.9 percent) and 419 (62.5 percent) were classified as prefrail and robust, respectively.

Compared with robust participants, those who were prefrail showed significantly lower TBV-to-eTIV ratio (59.0 vs 58.5; p<0.05) and a significantly higher WMHV-to-eTIV ratio (0.29 vs 0.35; p<0.05). All comparisons were made using values adjusted for confounders such as age, sex, comorbidities, blood lipid profile, and mental health measures.

Specifically, analysis according to the individual components of physical frailty revealed that participants with vs without slowness showed significant global matter atrophy (TBV-to-eTIV: 57.4 vs 59.0; p<0.05) and increased white matter hypointensity (0.49 vs 0.29; p<0.05). Weakness was likewise associated with white matter hypointensity (0.41 vs 0.31; p<0.05).

“The study findings showed that the prefrail state was significantly associated with global brain atrophy and cerebral small vessel disease in cognitively unimpaired general older adults. Additionally, physical frailty, as indicated by slowness, was significantly associated with hippocampal atrophy and cerebral small vessel disease,” the researchers said.

“Further prospective longitudinal studies and basic research are required to verify the findings of this study,” they added.