Frailty and Dementia

Most of us understand the definition of the word frail, and often we find ourselves using it to describe older adults we might see shuffling slowly, using a cane or walker, or suffering from vision and hearing impairments.

When healthy, we’re able to cope with the onslaught of everyday life, as well as weather the occasional setback, with processes such as the regulation of heart rate and blood pressure, muscle adjustments, hormone rhythms, and posture change. However, as we age, this can begin to change.

The concept of frailty, as it relates to the elderly, has become an emphasized concept in medicine in recent times, particularly in the field of geriatrics. Broadly defined, it is a state of increased vulnerability, which is as a result of declining function across multiple physiological systems, which make up a person’s ability to cope with everyday challenges and stressors. Frailty can also increase the risk of brain diseases, either on its own or as a manifestation of disease progression.

Research has indicated that a number of frailty factors that we may not associate with cognitive decline necessarily can have an impact on the development of dementia. The risk of developing cognitive impairment, progressing then to dementia, does not depend solely on the brain but rather on the entire person as a whole.

When mild cognitive impairment is characterized primarily by memory deficit, the risk of progressing to dementia is thought to be relatively high, and the underlying pathology is usually Alzheimer’s disease. But when assessing the risk it is imperative to go beyond the disease and the brain.