Physical frailty predicts future cognitive decline - a four-year prospective study in 2737 cognitively normal older adults.

OBJECTIVE: To examine the association between baseline frailty measurements and cognitive function 4 years later.

DESIGN: Prospective observational study.

SETTING: Community.

PARTICIPANTS: Two thousand seven hundred and thirty seven cognitively normal older adults.

MEASUREMENT: The appendicular muscle mass (ASM), hand grip strength, timed chair-stand test, walking speed and step length were measured at baseline. The Mini-mental state examination (MMSE) was administered at baseline and 4 years later.

RESULTS: In men, all baseline frailty measurements, namely, being underweight, lower ASM, weaker grip strength, slower chair-stand test, shorter step length, slower timed walk were significantly associated with a lower MMSE score 4 years afterwards. After adjustment for age, years of education and baseline MMSE score, ASM and timed walk became insignificant. In women, all frailty measurements except underweight and low ASM were significantly associated with MMSE score 4 years later. Moreover, only weaker grip strength persisted to be significant after adjustment for age, years of education and baseline MMSE score.

CONCLUSION: Physical frailty, as represented by being underweight, weaker grip strength, slower chair-stand test, shorter step-length in men and weaker grip strength in women, was associated with cognitive decline over a four year period.